Provider Demographics
NPI:1750892790
Name:DAVIS, BRIONNA SHEREE (RN)
Entity type:Individual
Prefix:
First Name:BRIONNA
Middle Name:SHEREE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5306 AMSDEN AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-2633
Mailing Address - Country:US
Mailing Address - Phone:419-262-7965
Mailing Address - Fax:
Practice Address - Street 1:5306 AMSDEN AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-2633
Practice Address - Country:US
Practice Address - Phone:419-262-7965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN.502674OtherREGISTERED NURSE