Provider Demographics
NPI:1295548758
Name:CHALK, DAVISHIA
Entity type:Individual
Prefix:
First Name:DAVISHIA
Middle Name:
Last Name:CHALK
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 1:5921 GREENSCAPE DR APT K
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-2862
Mailing Address - Country:US
Mailing Address - Phone:859-443-1487
Mailing Address - Fax:
Practice Address - Street 1:5921 GREENSCAPE DR APT K
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2862
Practice Address - Country:US
Practice Address - Phone:859-443-1487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide