Provider Demographics
NPI:1619554607
Name:DAVIS, CHAUNDRA
Entity Type:Individual
Prefix:
First Name:CHAUNDRA
Middle Name:
Last Name:DAVIS
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 1:12036 STEEPLECHASE AVE
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8606
Mailing Address - Country:US
Mailing Address - Phone:614-859-5711
Mailing Address - Fax:
Practice Address - Street 1:12036 STEEPLECHASE AVE
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-8606
Practice Address - Country:US
Practice Address - Phone:614-859-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula