Provider Demographics
NPI:1235939547
Name:DAVIS, JALANA
Entity type:Individual
Prefix:
First Name:JALANA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 N 108TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-2943
Mailing Address - Country:US
Mailing Address - Phone:402-201-3143
Mailing Address - Fax:402-973-1092
Practice Address - Street 1:3824 N 108TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-2943
Practice Address - Country:US
Practice Address - Phone:402-201-3143
Practice Address - Fax:402-973-1092
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide