Provider Demographics
NPI:1467279497
Name:DAVIS, TASHIA MELANIE
Entity type:Individual
Prefix:
First Name:TASHIA
Middle Name:MELANIE
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 1:587 PARTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:OH
Mailing Address - Zip Code:43056-1338
Mailing Address - Country:US
Mailing Address - Phone:740-403-1891
Mailing Address - Fax:
Practice Address - Street 1:587 PARTRIDGE RD
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:OH
Practice Address - Zip Code:43056-1338
Practice Address - Country:US
Practice Address - Phone:740-403-1891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2131455251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health