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General NPI Number Information
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NPI Number | 1164317848
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Entity Type | Individual
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Provider Name | DARYL DAVENPORT
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Gender |
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 2707 L ST
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City | ORD
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State | NE
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Zip | 68862-1275
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Country | US
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Telephone | 308-728-4355
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Fax |
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Provider Business Mailing Address
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Address Line | 47278 818TH RD
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City | ELYRIA
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State | NE
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Zip | 68837-7101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 38757
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License Number State | NE
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