Provider Demographics
NPI:1649038563
Name:DAVIS, TYSHEKA
Entity type:Individual
Prefix:
First Name:TYSHEKA
Middle Name:
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 1:3866 DICKERSON PIKE STE 3
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-1300
Mailing Address - Country:US
Mailing Address - Phone:615-939-7578
Mailing Address - Fax:
Practice Address - Street 1:3866 DICKERSON PIKE STE 3
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-1300
Practice Address - Country:US
Practice Address - Phone:615-939-7578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care