Provider Demographics
NPI:1083355960
Name:DAVIS, DARLEASE R (APRN)
Entity Type:Individual
Prefix:
First Name:DARLEASE
Middle Name:R
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7593 SUN VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9088
Mailing Address - Country:US
Mailing Address - Phone:901-786-3967
Mailing Address - Fax:
Practice Address - Street 1:7593 SUN VALLEY CT
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9088
Practice Address - Country:US
Practice Address - Phone:901-786-3967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH414246163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine