Provider Demographics
NPI:1790542504
Name:DAVIS, BETH CHANEY
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:CHANEY
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 1:6803 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:OH
Mailing Address - Zip Code:45817-9550
Mailing Address - Country:US
Mailing Address - Phone:419-305-9620
Mailing Address - Fax:
Practice Address - Street 1:5750 SCHUNK RD
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-9524
Practice Address - Country:US
Practice Address - Phone:419-305-9620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker