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NPI Code Detail

MEDICARE: TAMYIA SIMONE DAVIS

MEDICARE: TAMYIA SIMONE 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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1720573363
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMYIA SIMONE DAVIS
Provider Business Mailing Address
First Line : 3138 BUENA VISTA TER SE APT 2
Second Line :
City : WASHINGTON
State : DC
Zip : 20020-1707
Country : US
Telephone Number : 202-725-9455
Fax Number :
Provider Business Practice Location Address
First Line : 3138 BUENA VISTA TER SE APT 2
Second Line :
City : WASHINGTON
State : DC
Zip : 20020-1707
Country : US
Telephone Number : 202-725-9455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2018
Last Update Date : 06/26/2018

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Directions to “ TAMYIA SIMONE DAVIS ” Practice Location

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