Individual
CHARISSE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 MAIN ST, WAYNESVILLE, MO 65583-2031
(573) 889-7203
Mailing address
510 MAIN ST, WAYNESVILLE, MO 65583-2031
(573) 889-8414
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
W105050002
MO
372600000X
Adult Companion
134186B
MO
374U00000X
Home Health Aide
134186B
MO
376K00000X
Nurse's Aide
134186B
MO
Other
Enumeration date
04/28/2020
Last updated
04/28/2020
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