Maryellen Ann Davison, RN

Individual provider Active NPI School Registered Nurse · Cleveland, NY

NPI 1881968337 · NPPES record last updated Mar 1, 2012

Key facts

NPI
1881968337
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
358624-1 (NY)
Practice address
140 Bridge St
Cleveland, NY 13042-3144
Phone
(315) 675-3172
Fax
(315) 675-3018
NPI assigned
Mar 1, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
358624-1NYMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 358624-1 NY Yes

Addresses

Primary practice location

140 Bridge St
Cleveland, NY 13042-3144

Mailing address

140 Bridge St
Cleveland, NY 13042-3144
Phone (315) 675-3172

Other providers in Cleveland, NY

All providers in Cleveland, NY · School Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.