Provider Demographics
NPI:1124901376
Name:ARTIS, ANTAVIA
Entity type:Individual
Prefix:
First Name:ANTAVIA
Middle Name:
Last Name:ARTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANTAVIA
Other - Middle Name:
Other - Last Name:SHORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1501 GETTYSBURG DR
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-5314
Mailing Address - Country:US
Mailing Address - Phone:216-882-3040
Mailing Address - Fax:
Practice Address - Street 1:1501 GETTYSBURG DR
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-5314
Practice Address - Country:US
Practice Address - Phone:216-882-3040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion