Provider Demographics
NPI:1376433862
Name:DAVIS, KAYSHA LYNN
Entity type:Individual
Prefix:
First Name:KAYSHA
Middle Name:LYNN
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 1:405 27TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-0746
Mailing Address - Country:US
Mailing Address - Phone:701-240-1546
Mailing Address - Fax:
Practice Address - Street 1:1400 35TH AVE NW APT 303
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-2728
Practice Address - Country:US
Practice Address - Phone:503-857-2162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide