Healthcare Provider Details

I. General information

NPI: 1124981196
Provider Name (Legal Business Name): MS. MARKEITHA DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2463 OAKLEAF CIR
LITHONIA GA
30058-6635
US

IV. Provider business mailing address

2463 OAKLEAF CIR
LITHONIA GA
30058-6635
US

V. Phone/Fax

Practice location:
  • Phone: 404-553-5351
  • Fax:
Mailing address:
  • Phone: 404-553-5351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: