Provider Demographics
NPI:1053951004
Name:HASSAN-DAVIS, AISHA (PMHNP)
Entity type:Individual
Prefix:
First Name:AISHA
Middle Name:
Last Name:HASSAN-DAVIS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MISS
Other - First Name:AISHA
Other - Middle Name:
Other - Last Name:HASSAN-DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:564 COLDWATER DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:DE
Mailing Address - Zip Code:19938-3905
Mailing Address - Country:US
Mailing Address - Phone:410-855-4664
Mailing Address - Fax:855-461-3481
Practice Address - Street 1:8707 COMMERCE DR STE E
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-6910
Practice Address - Country:US
Practice Address - Phone:410-855-4664
Practice Address - Fax:855-461-3481
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC002974363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDAC002974OtherPMHNP
MDFT780001OtherBCBS