MEDICARE: JAKIRA DARIELLE DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide	1356212393	ND

General Provider Information

NPI Number	:	1356212393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAKIRA DARIELLE DAVIS

Provider Business Mailing Address
First Line	:	2532 COLONIAL DR
Second Line	:
City	:	BISMARCK
State	:	ND
Zip	:	58503-5804
Country	:	US
Telephone Number	:	213-819-4396
Fax Number	:

Provider Business Practice Location Address
First Line	:	2532 COLONIAL DR
Second Line	:
City	:	BISMARCK
State	:	ND
Zip	:	58503-5804
Country	:	US
Telephone Number	:	213-819-4396
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	03/18/2026

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Directions to “ JAKIRA DARIELLE DAVIS ” Practice Location

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