Provider Demographics
NPI:1467162875
Name:DAVIS, TYREEN M I
Entity Type:Individual
Prefix:
First Name:TYREEN
Middle Name:M
Last Name:DAVIS
Suffix:I
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 1:732 WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-1126
Mailing Address - Country:US
Mailing Address - Phone:740-423-9729
Mailing Address - Fax:
Practice Address - Street 1:732 WESTVIEW DR
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1126
Practice Address - Country:US
Practice Address - Phone:740-423-9729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide