Healthcare Provider Details

I. General information

NPI: 1528236650
Provider Name (Legal Business Name): KENISHA LA'TRECE DAVIS APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7593 TYLERS PLACE BLVD
WEST CHESTER OH
45069-6308
US

IV. Provider business mailing address

8350 RIDGEVALLEY CT
CINCINNATI OH
45247-3596
US

V. Phone/Fax

Practice location:
  • Phone: 513-909-2225
  • Fax: 513-428-1715
Mailing address:
  • Phone: 513-886-2367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-CNP-17420
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP 17420
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN286523
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: