Provider Demographics
NPI:1134701311
Name:DAVIS, CARMEN J
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:J
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 1:2201 CHAMPLAIN ST NW APT 103
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2683
Mailing Address - Country:US
Mailing Address - Phone:202-612-0023
Mailing Address - Fax:
Practice Address - Street 1:2201 CHAMPLAIN ST NW APT 103
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2683
Practice Address - Country:US
Practice Address - Phone:202-612-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion