Provider Demographics
NPI:1578500633
Name:DAVIS, CHERYL ANN (NP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 MERCY HEALTH BLVD STE 285
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-1106
Mailing Address - Country:US
Mailing Address - Phone:513-215-9457
Mailing Address - Fax:513-215-9458
Practice Address - Street 1:3301 MERCY HEALTH BLVD STE 285
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1106
Practice Address - Country:US
Practice Address - Phone:513-215-9457
Practice Address - Fax:513-215-9458
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP05089363LX0001X
KY3424P363L00000X
OHNP-05089363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311074519202OtherCARESOURCE
OH4310781Medicare PIN
P15788Medicare UPIN