Provider Demographics
NPI:1265798284
Name:DAVIS, DENISE (CNA, MA)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CNA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 ELMIRA AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-2409
Mailing Address - Country:US
Mailing Address - Phone:504-338-1133
Mailing Address - Fax:
Practice Address - Street 1:724 ELMIRA AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-2409
Practice Address - Country:US
Practice Address - Phone:504-338-1133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide