Provider Demographics
NPI:1760628770
Name:DAVIS, JODY EICHHORN (RN)
Entity Type:Individual
Prefix:MRS
First Name:JODY
Middle Name:EICHHORN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:JODY
Other - Middle Name:EICHHORN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW
Mailing Address - Street 1:7771 GLENHOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5906
Mailing Address - Country:US
Mailing Address - Phone:513-503-6185
Mailing Address - Fax:
Practice Address - Street 1:5354 N HIGH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1295
Practice Address - Country:US
Practice Address - Phone:614-948-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1600754101YM0800X
OH335823163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse