Provider Demographics
NPI:1487220190
Name:DAVIS-SHEIKHI, LISA LATONYA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LATONYA
Last Name:DAVIS-SHEIKHI
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 1:2960 AMBARWENT RD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-8223
Mailing Address - Country:US
Mailing Address - Phone:614-323-1762
Mailing Address - Fax:
Practice Address - Street 1:2960 AMBARWENT RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-8223
Practice Address - Country:US
Practice Address - Phone:614-323-1762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH178488164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse