Provider Demographics
NPI:1306218128
Name:DAVIS, SHERRY RENE (HHA)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:RENE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 SHADY LANE ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-2512
Mailing Address - Country:US
Mailing Address - Phone:614-603-0229
Mailing Address - Fax:
Practice Address - Street 1:4242 SHADY LANE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-2512
Practice Address - Country:US
Practice Address - Phone:614-603-0229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide