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NPI Code Detail

MEDICARE: ZENOBRA DAVIS

MEDICARE: ZENOBRA 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
1171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508062415
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZENOBRA DAVIS
Provider Business Mailing Address
First Line : PO BOX 89
Second Line :
City : VANNDALE
State : AR
Zip : 72387-0089
Country : US
Telephone Number : 870-318-6727
Fax Number : 501-265-0300
Provider Business Practice Location Address
First Line : 6210 BASELINE RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72209-4728
Country : US
Telephone Number : 501-265-0302
Fax Number : 501-265-0300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2007
Last Update Date : 05/25/2022

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Directions to “ ZENOBRA DAVIS ” Practice Location

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