Provider Demographics
NPI:1699393645
Name:DAVIS, LANIQUE ASHAWN
Entity Type:Individual
Prefix:MISS
First Name:LANIQUE
Middle Name:ASHAWN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LANIQUE
Other - Middle Name:ASHAWN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3318 CURTIS DR
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-2655
Mailing Address - Country:US
Mailing Address - Phone:202-403-1326
Mailing Address - Fax:
Practice Address - Street 1:3318 CURTIS DR APT 204
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-2655
Practice Address - Country:US
Practice Address - Phone:202-403-1326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide