Healthcare Provider Details

I. General information

NPI: 1780497883
Provider Name (Legal Business Name): HEATHER NICOLE DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER NICOLE HAMILTON

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7091 BEECHMONT AVE
CINCINNATI OH
45230-2978
US

IV. Provider business mailing address

7091 BEECHMONT AVE
CINCINNATI OH
45230-2978
US

V. Phone/Fax

Practice location:
  • Phone: 513-582-4023
  • Fax:
Mailing address:
  • Phone: 513-582-4023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: