Basic Information
| Provider Information | |||||||||
| NPI: | 1720171762 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVENPORT | ||||||||
| FirstName: | ABIGAIL | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6608 BIRCHLEIGH WAY | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 223153620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7033139064 | ||||||||
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| Practice Location | |||||||||
| Address1: | 110 IRVING ST NW | ||||||||
| Address2: | WASHINGTON HEART | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200102976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028778895 | ||||||||
| FaxNumber: | 2028778894 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN68198 | DC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.