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General NPI Number Information
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NPI Number | 1326306069
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Entity Type | Individual
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Provider Name | RAQUEL ANITA DAVIS PMHNP
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Gender | Female
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Dates
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Enumeration Date | 05/01/2012
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 22072 MARBERRY CMNS
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City | BEDFORD HEIGHTS
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State | OH
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Zip | 44146-6800
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Country | US
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Telephone | 216-376-2916
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Fax |
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Provider Business Mailing Address
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Address Line | 24500 CENTER RIDGE RD STE 200
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City | WESTLAKE
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State | OH
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Zip | 44145-5630
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Country | US
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Telephone | 440-201-4488
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Fax | 440-385-7019
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0036127
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License Number State | OH
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