Provider Demographics
NPI:1376251801
Name:DAVIS, VALERIE DENISE
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:DENISE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:DENISE
Other - Last Name:MASON-BOWDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:441 TORONTO CIR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-5382
Mailing Address - Country:US
Mailing Address - Phone:678-836-9865
Mailing Address - Fax:
Practice Address - Street 1:441 TORONTO CIR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-5382
Practice Address - Country:US
Practice Address - Phone:678-836-9865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care
No332U00000XSuppliersHome Delivered Meals
No372500000XNursing Service Related ProvidersChore Provider