Doctor Name: | MRS. REBECCA LEE DAVIS |
NPI Number: | 1073549812 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | HS2 |
License Number: | |
Business Practice Address: | 4000 Coast Guard Blvd Portsmouth, VA - 237032135 |
Business Phone Number: | 7574838597 |
Business Fax Number: | 7574838610 |
Mailing Address: | 4000 Coast Guard Blvd, PORTSMOUTH |
State: | VA |
Postal Code: | 237032135 |
Phone Number: | 7574838597 |
Fax Number: | 7574838610 |
NPI Enumeration Date: | 06/23/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |