MEDICARE: NEKIA SHARISSE DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1255938445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEKIA SHARISSE DAVIS

Provider Business Mailing Address
First Line	:	2004 38TH ST SE APT 301
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-2436
Country	:	US
Telephone Number	:	202-840-2557
Fax Number	:

Provider Business Practice Location Address
First Line	:	933 N ST NW APT 102
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20001-4248
Country	:	US
Telephone Number	:	202-368-7626
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2020
Last Update Date	:	10/01/2020

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Directions to “ NEKIA SHARISSE DAVIS ” Practice Location

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