Provider Demographics
NPI:1891066676
Name:DAVIS, SHAMEKA L
Entity Type:Individual
Prefix:
First Name:SHAMEKA
Middle Name:L
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 1:5336 LA QUINTA HILLS ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-2930
Mailing Address - Country:US
Mailing Address - Phone:702-518-4331
Mailing Address - Fax:
Practice Address - Street 1:5336 LAQUINTA HILLS ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-2930
Practice Address - Country:US
Practice Address - Phone:702-518-4331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No251G00000XAgenciesHospice Care, Community Based
No376K00000XNursing Service Related ProvidersNurse's Aide