Healthcare Provider Details

I. General information

NPI: 1063346922
Provider Name (Legal Business Name): KERRY DAVIES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 S BROADWAY ST
AKRON OH
44308-1529
US

IV. Provider business mailing address

1228 NORTHEAST AVE
TALLMADGE OH
44278-1164
US

V. Phone/Fax

Practice location:
  • Phone: 330-253-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN.465677
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: