Provider Demographics
NPI:1194950469
Name:DAVIS, VILLA JANINE (LPN)
Entity type:Individual
Prefix:MS
First Name:VILLA
Middle Name:JANINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27621 CHAGRIN BLVD.
Mailing Address - Street 2:APT. # 229
Mailing Address - City:WOODMERE
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4491
Mailing Address - Country:US
Mailing Address - Phone:216-322-0364
Mailing Address - Fax:216-342-4714
Practice Address - Street 1:27621 CHAGRIN BLVD
Practice Address - Street 2:APT. # 229
Practice Address - City:WOODMERE
Practice Address - State:OH
Practice Address - Zip Code:44122-4420
Practice Address - Country:US
Practice Address - Phone:216-322-0364
Practice Address - Fax:216-342-4714
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 117942164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse