ELIZABETH JANE DAVIDSON (FNP-BC) – Family Nurse Practitioner, NPI 1245038371

ELIZABETH JANE DAVIDSON (FNP-BC) is a healthcare provider. based in Saint michael, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-BC. They hold a License No. 12314 (MN). The NPI Number for ELIZABETH JANE DAVIDSON (FNP-BC) is 1245038371

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
ELIZABETH JANE DAVIDSON (FNP-BC)
NPI
1245038371
Phone
(218) 205-4996
Address
9859 51ST ST NE
Enumeration Date
5 March 2025
Last Update Date
5 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6306322648
Graduation Year
2024 (2 years ago)
PAC ID
4981120375
Group Practice PAC ID
5193194728
Professional Enrollment ID
I20250429001803
Address ID
MN554464003PL15655NXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for ELIZABETH JANE DAVIDSON (FNP-BC)

  • 9859 51ST ST NE

    SAINT MICHAEL, MN 553767506

    Phone: (218) 205-4996

    Type: Mailing

  • 9825 HOSPITAL DR

    MAPLE GROVE, MN 553694479

    Phone: (612) 293-7822

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250429001803INurse PractitionerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55376)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5193194728View full group profile
NameSpecialtyState
Nurse PractitionerMN
D E R M A T O L O G YMN
D E R M A T O L O G YMN

Reviews

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Frequently asked questions

Is ELIZABETH JANE DAVIDSON (FNP-BC) listed with a National Provider Identifier?
Yes — ELIZABETH JANE DAVIDSON (FNP-BC) has NPI 1245038371 on file in the registry.
Active or inactive — what applies to ELIZABETH JANE DAVIDSON (FNP-BC)?
You should see ELIZABETH JANE DAVIDSON (FNP-BC) as active in CMS-hosted NPPES data.
What kind of doctor is ELIZABETH JANE DAVIDSON (FNP-BC)?
ELIZABETH JANE DAVIDSON (FNP-BC) is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for ELIZABETH JANE DAVIDSON (FNP-BC)?
Travel planning: use Saint Michael, Minnesota as the reference point for ELIZABETH JANE DAVIDSON (FNP-BC), then confirm.
When was this NPI issued?
Enumeration for ELIZABETH JANE DAVIDSON (FNP-BC) is noted as March 5, 2025 where the registry provides it.

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