Provider Demographics
NPI:1972066819
Name:DAVIS, JAMECIA NATAYE
Entity Type:Individual
Prefix:
First Name:JAMECIA
Middle Name:NATAYE
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 1:12416 EXCALIBUR AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2410
Mailing Address - Country:US
Mailing Address - Phone:225-413-6252
Mailing Address - Fax:
Practice Address - Street 1:6803 BAYOU SARA WAY
Practice Address - Street 2:
Practice Address - City:SAINT FRANCISVILLE
Practice Address - State:LA
Practice Address - Zip Code:70775-6684
Practice Address - Country:US
Practice Address - Phone:225-413-6252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-08
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)