Healthcare Provider Details

I. General information

NPI: 1477797231
Provider Name (Legal Business Name): ANTOINETTE FENI DAVIS APRFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2009
Last Update Date: 03/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7217 CINCINNATI DAYTON RD
WEST CHESTER OH
45069-1547
US

IV. Provider business mailing address

909 TWINCREST CT
CINCINNATI OH
45231-3815
US

V. Phone/Fax

Practice location:
  • Phone: 513-759-3300
  • Fax:
Mailing address:
  • Phone: 513-335-3765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18104
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number348835
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: