Provider Demographics
NPI:1942833751
Name:DAVIS, DENISE (CERTIFIED NURSE ASSI)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CERTIFIED NURSE ASSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11667 E US HIGHWAY 82 # 23
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76273-5236
Mailing Address - Country:US
Mailing Address - Phone:469-560-1681
Mailing Address - Fax:
Practice Address - Street 1:11667 US82 #23
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:TX
Practice Address - Zip Code:76273
Practice Address - Country:US
Practice Address - Phone:469-395-8620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X, 253Z00000X
KS153796376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion
No376K00000XNursing Service Related ProvidersNurse's Aide