Provider Demographics
NPI:1689259046
Name:DAVIS, YASHIA VASHONDA (CNA)
Entity Type:Individual
Prefix:
First Name:YASHIA
Middle Name:VASHONDA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7137 HIGHWAY 45 ALT N STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-9444
Mailing Address - Country:US
Mailing Address - Phone:662-295-9164
Mailing Address - Fax:
Practice Address - Street 1:7137 HIGHWAY 45 ALT N STE 1
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-9444
Practice Address - Country:US
Practice Address - Phone:662-295-9164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide