Provider Demographics
NPI:1609531763
Name:DAVIS, ANDREA D (RESPIRATORY THERAPIS)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:D
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RESPIRATORY THERAPIS
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:D
Other - Last Name:HENSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RESPIRATORY THERAPIS
Mailing Address - Street 1:6856 HIWASSEE RD
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141-8328
Mailing Address - Country:US
Mailing Address - Phone:276-345-2389
Mailing Address - Fax:
Practice Address - Street 1:6856 HIWASSEE RD
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141-8328
Practice Address - Country:US
Practice Address - Phone:276-345-2389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified