Provider Demographics
NPI:1790429181
Name:DAVIS, BYTHIA AMANDA (CNA)
Entity Type:Individual
Prefix:
First Name:BYTHIA
Middle Name:AMANDA
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 1:7708 W GERTRUDE DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-3738
Mailing Address - Country:US
Mailing Address - Phone:414-446-1606
Mailing Address - Fax:
Practice Address - Street 1:7708 W GERTRUDE DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-3738
Practice Address - Country:US
Practice Address - Phone:414-446-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care