Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Elizabeth Jane Davidson, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1245038371

Elizabeth Jane Davidson, FNP-BC is a Nurse Practitioner in Maple Grove, Minnesota. Qualified in 2024, 2 years ago. Practices with Mittal Dermatology, PA, a 5-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
2
Licensed in
MN
In the registry since
2025
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

9825 Hospital Dr
Maple Grove, MN 55369-4479
Phone: (612) 293-7822
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 12314 (MN)

Record details

NPI number1245038371
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorYes
NPI enumeratedMarch 5, 2025
Last updated in NPPESMarch 5, 2025
Certification dateMarch 5, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Mittal Dermatology, Pa — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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