Individual
D'JARA LYSETTE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3607 ELLIS WAY, MIDDLETOWN, OH 45044-6520
(513) 267-8556
Mailing address
3607 ELLIS WAY, MIDDLETOWN, OH 45044-6520
(513) 267-8556
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.129816
OH
Other
Enumeration date
05/11/2009
Last updated
05/11/2009
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