Individual
SHIANDRA KEYATA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4201 S IRBY ST LOT 14, FLORENCE, SC 29505-5311
(843) 373-8284
Mailing address
4201 S IRBY ST LOT 14, FLORENCE, SC 29505-5311
(843) 373-8284
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01151991
—
SC
Enumeration date
06/30/2019
Last updated
05/11/2026
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