Mimi Lea Davidson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F10230912 Issued in NC

Practice address

8223 S. Quebec St.
Suiite C
Centennial, CO 80112

Phone

(303) 324-8789

NPI assigned

Apr 12, 2024

Last updated

Apr 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Lea Davidson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1790539286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8223 S. QUEBEC ST.",
            "address_2": "SUIITE C",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8223 S. QUEBEC ST.",
            "address_2": "SUIITE C",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80112",
            "telephone_number": "303-324-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MIMI LEA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F10230912",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NC",
            "license": "229329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEA",
            "last_name": "DAVIDSON",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Genevie Davenport
• Laurie Davenport, LCSW, LAC
• McKenzie Davenport, LAC
• Megan Davey Franklin, LPC
• David E. Lindeman DDS, Ms, PC
• Jennifer Lea Davies, LAC, NCMT
• Lisa Davila
• Alice Davis, MSPT
• Ashley Davis
• Carly Davis, PHARM.D

• Family Nurse Practitioner in Centennial, CO
• Providers in Centennial, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.