Provider Demographics
NPI:1124751078
Name:DAVIS, SHAKIARA TAVONNE (CNA)
Entity type:Individual
Prefix:
First Name:SHAKIARA
Middle Name:TAVONNE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3051 ARCADIA AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-1227
Mailing Address - Country:US
Mailing Address - Phone:402-201-1538
Mailing Address - Fax:
Practice Address - Street 1:3051 ARCADIA AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-1227
Practice Address - Country:US
Practice Address - Phone:402-201-4689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide