| Doctor Name: | MS. KATHY DAVIDSON |
| NPI Number: | 1730513854 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | N-18832 |
| Business Practice Address: | 85 S Main St Driggs, ID - 834229700 |
| Business Phone Number: | 2083543005 |
| Business Fax Number: | |
| Mailing Address: | 301 Honeysuckle Loop, DRIGGS |
| State: | ID |
| Postal Code: | 834225385 |
| Phone Number: | 2088412106 |
| Fax Number: | |
| NPI Enumeration Date: | 08/26/2013 |
| NPI Last Update Date: | 08/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | N-18832 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |