Provider Demographics
NPI:1871728519
Name:DAVIS, CYNTHIA A
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6880 BRANDYWINE ST APT 25
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-7242
Mailing Address - Country:US
Mailing Address - Phone:513-253-2825
Mailing Address - Fax:
Practice Address - Street 1:6880 BRANDYWINE ST APT 25
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-7242
Practice Address - Country:US
Practice Address - Phone:513-253-2825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN129299164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse