Provider Demographics
NPI:1073101432
Name:DAVIS, SHERIKA (CPHT)
Entity Type:Individual
Prefix:
First Name:SHERIKA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BOGEY LN APT 12
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-8002
Mailing Address - Country:US
Mailing Address - Phone:501-240-8391
Mailing Address - Fax:
Practice Address - Street 1:11 BOGEY LN APT 12
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-8002
Practice Address - Country:US
Practice Address - Phone:501-240-8391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-01
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212847183700000X
ARPT92668183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician