Provider Demographics
NPI:1356106900
Name:DAVIS, YOLANDA RENEE
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:RENEE
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 1:2612 BRIARBERRY PL
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35226-3816
Mailing Address - Country:US
Mailing Address - Phone:205-706-7110
Mailing Address - Fax:
Practice Address - Street 1:2612 BRIARBERRY PL
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35226-3816
Practice Address - Country:US
Practice Address - Phone:205-706-7110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program