Provider Demographics
NPI:1922981430
Name:DAVIS, LATISHIA D
Entity type:Individual
Prefix:
First Name:LATISHIA
Middle Name:D
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 1:3004 WYNFALL LN SW APT B
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-9676
Mailing Address - Country:US
Mailing Address - Phone:252-314-0002
Mailing Address - Fax:
Practice Address - Street 1:3004 WYNFALL LN SW APT B
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-9676
Practice Address - Country:US
Practice Address - Phone:252-314-0002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care