Provider Demographics
NPI:1619783925
Name:DAVISON, BRIAN DONALD
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:DONALD
Last Name:DAVISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048-1932
Mailing Address - Country:US
Mailing Address - Phone:402-890-5689
Mailing Address - Fax:
Practice Address - Street 1:224 N 6TH ST
Practice Address - Street 2:
Practice Address - City:PLATTSMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68048-1932
Practice Address - Country:US
Practice Address - Phone:402-890-5689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion