Individual
MS. DEBRA R DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
446 LILY ST, MANSFIELD, OH 44903-1313
(419) 522-1205
Mailing address
446 LILY ST, MANSFIELD, OH 44903-1313
(419) 522-1205
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2648880
—
OH
Enumeration date
04/10/2012
Last updated
04/10/2012
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