Provider Demographics
NPI:1942823224
Name:DAVIS, ALEXANDRIA CYMONE (LVN)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:CYMONE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:GRAPELAND
Mailing Address - State:TX
Mailing Address - Zip Code:75844-2149
Mailing Address - Country:US
Mailing Address - Phone:946-204-9514
Mailing Address - Fax:
Practice Address - Street 1:309 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:GRAPELAND
Practice Address - State:TX
Practice Address - Zip Code:75844-2149
Practice Address - Country:US
Practice Address - Phone:946-204-9514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX352173164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse