Healthcare Provider Details

I. General information

NPI: 1043089188
Provider Name (Legal Business Name): NAQUIMIA DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2024
Last Update Date: 07/24/2025
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 BRYDEN RD. STE. 122
COLUMBUS OH
43215
US

IV. Provider business mailing address

700 BRYDEN RD. STE. 122 ,COLUMBUS OHIO 43215
COLUMBUS OH
43215
US

V. Phone/Fax

Practice location:
  • Phone: 614-681-0012
  • Fax: 614-412-6944
Mailing address:
  • Phone: 614-681-0012
  • Fax: 614-412-6944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberRZ086314
License Number StateOH
# 7
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: