Provider Demographics
NPI:1841847944
Name:DAVIS, NENA YAUN
Entity type:Individual
Prefix:
First Name:NENA
Middle Name:YAUN
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:PO BOX 682
Mailing Address - Street 2:
Mailing Address - City:TOM BEAN
Mailing Address - State:TX
Mailing Address - Zip Code:75489-0682
Mailing Address - Country:US
Mailing Address - Phone:903-819-7447
Mailing Address - Fax:
Practice Address - Street 1:206 E. BONHAM ST.
Practice Address - Street 2:
Practice Address - City:TOM BEAN
Practice Address - State:TX
Practice Address - Zip Code:75489
Practice Address - Country:US
Practice Address - Phone:903-819-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX349672164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse