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General NPI Number Information
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NPI Number | 1194950469
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Entity Type | Individual
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Provider Name | VILLA JANINE DAVIS LPN
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Gender | Female
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Dates
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Enumeration Date | 05/15/2009
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Last Update Date | 05/15/2009
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Provider Practice Location Address
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Address Line | 27621 CHAGRIN BLVD APT. # 229
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City | WOODMERE
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State | OH
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Zip | 44122-4420
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Country | US
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Telephone | 216-322-0364
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Fax | 216-342-4714
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Provider Business Mailing Address
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Address Line | 27621 CHAGRIN BLVD. APT. # 229
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City | WOODMERE
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State | OH
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Zip | 44122-4491
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Country | US
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Telephone | 216-322-0364
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Fax | 216-342-4714
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN. 117942
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License Number State | OH
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