Individual provider · Type 1 NPI
Stacy Davidson, CPNP-AC
Pediatric Nurse Practitioner · Sacramento, CA
NPI number
1467028209
Active
Practice location
2315 Stockton Blvd
Sacramento, CA 95817-2201
Mailing address
2432 Meadowlark Cir
West Sacramento, CA 95691-4628
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 95003179 (CA) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1467028209
Stacy Davidson, CPNP-AC's National Provider Identifier is 1467028209, issued on Jun 2, 2021. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Sacramento, CA. The record was last updated on Oct 13, 2021.