Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 020655 | TN |
NPI | 1083724017 |
---|---|
Provider Name | Evelyne Monique Davidson |
First Address | Knoxville, TN 37914-5007 |
Second Address | Knoxville, TN 37914-5007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 10/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100022381 | PHP TNCARE (01) | TN |
110221350 | RAILROAD MEDICARE (01) | TN |
30519801 | (05) | TN |
3051987 | (05) | TN |
3704598 | (05) | TN |
4007807 | BLUE CROSS (01) | TN |
602002790 | CARITEN (01) | TN |
E43133 | (02) |