Provider Demographics
NPI:1477797231
Name:DAVIS, ANTOINETTE FENI (APRFNP)
Entity Type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:FENI
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APRFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 TWINCREST CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3815
Mailing Address - Country:US
Mailing Address - Phone:513-335-3765
Mailing Address - Fax:
Practice Address - Street 1:7217 CINCINNATI DAYTON RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-1547
Practice Address - Country:US
Practice Address - Phone:513-759-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH348835163W00000X
OH18104363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH363LF0000XMedicaid