Provider Demographics
NPI:1669839775
Name:DAVISBELL, THELMA
Entity type:Individual
Prefix:
First Name:THELMA
Middle Name:
Last Name:DAVISBELL
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 1:8017 CHRISWOODS CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828-4893
Mailing Address - Country:US
Mailing Address - Phone:916-206-9056
Mailing Address - Fax:
Practice Address - Street 1:8017 CHRISWOODS CT
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-4893
Practice Address - Country:US
Practice Address - Phone:916-206-9056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN249660164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse