Provider Demographics
NPI:1588008023
Name:DAVIS, ARNETTA MICHELLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ARNETTA
Middle Name:MICHELLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11901 SILMOR AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-1575
Mailing Address - Country:US
Mailing Address - Phone:216-618-5571
Mailing Address - Fax:
Practice Address - Street 1:11901 SILMOR AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-1575
Practice Address - Country:US
Practice Address - Phone:216-618-5571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-27
Last Update Date:2013-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH151143167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician