MEDICARE: YOLONDA 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	183700000X	Pharmacy Technician	0230030178	VA

General Provider Information

NPI Number	:	1366129801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLONDA DAVIS

Provider Business Mailing Address
First Line	:	4214 JEFFERSON AVE
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23607-2824
Country	:	US
Telephone Number	:	757-243-4302
Fax Number	:

Provider Business Practice Location Address
First Line	:	3501 MARSHALL AVE APT A
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23607-3031
Country	:	US
Telephone Number	:	757-243-4302
Fax Number	:

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

Provider Enumeration Date	:	06/28/2023
Last Update Date	:	06/28/2023

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Directions to “ YOLONDA DAVIS ” Practice Location

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