MEDICARE: NOTKIA S 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	246RP1900X	Phlebotomy Technician	NPCN-17790-18539	WI

General Provider Information

NPI Number	:	1821924127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOTKIA S DAVIS

Provider Business Mailing Address
First Line	:	W62N217 WASHINGTONAVE
Second Line	:
City	:	CEDARBURG
State	:	WI
Zip	:	53012
Country	:	US
Telephone Number	:	414-484-1429
Fax Number	:

Provider Business Practice Location Address
First Line	:	W62N217 WASHINGTONAVE
Second Line	:
City	:	CEDARBURG
State	:	WI
Zip	:	53012
Country	:	US
Telephone Number	:	414-484-1429
Fax Number	:

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

Provider Enumeration Date	:	06/23/2026
Last Update Date	:	06/23/2026

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Directions to “ NOTKIA S DAVIS ” Practice Location

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