Provider Demographics
NPI:1255104360
Name:DAVIS, DEVANY LEEANN
Entity type:Individual
Prefix:
First Name:DEVANY
Middle Name:LEEANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4277 BUCK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-4891
Mailing Address - Country:US
Mailing Address - Phone:614-972-2323
Mailing Address - Fax:
Practice Address - Street 1:30 E BROAD ST FL 13
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3414
Practice Address - Country:US
Practice Address - Phone:800-617-6733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUM6622863747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider