Individual
MARYAM JALILA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED NURSING AS
Contact information
Practice address
5150 N 99TH AVE APT 3091, GLENDALE, AZ 85305-3034
(602) 516-5096
Mailing address
5150 N 99TH AVE APT 3091, GLENDALE, AZ 85305-3034
(602) 516-5096
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
—
—
376K00000X
Nurse's Aide
Primary
1000048010
AZ
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
04/06/2020
Last updated
04/06/2020
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