Provider Demographics
NPI:1417946336
Name:DAVIS, JOANNE P (PHDC, CNM)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:P
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHDC, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1104
Mailing Address - Country:US
Mailing Address - Phone:740-773-4366
Mailing Address - Fax:740-775-7855
Practice Address - Street 1:1049 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1104
Practice Address - Country:US
Practice Address - Phone:740-773-4366
Practice Address - Fax:740-775-7855
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN131789163WM0102X, 163WW0101X
OHNM3524163WM0102X, 163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
Not Answered163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2404651Medicaid
OHDA2026144Medicare ID - Type UnspecifiedNEW LEXINGTON OHIO OFFICE
R96624Medicare UPIN
OHDA2026142Medicare ID - Type UnspecifiedCHILLICOTHE OHIO OFFICE
OHDA2026143Medicare ID - Type UnspecifiedMCARTHUR OHIO OFFICE
OH2404651Medicaid