Provider Demographics
NPI:1043089188
Name:DAVIS, NAQUIMIA
Entity type:Individual
Prefix:
First Name:NAQUIMIA
Middle Name:
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 1:700 BRYDEN RD STE 122
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215
Mailing Address - Country:US
Mailing Address - Phone:614-681-0012
Mailing Address - Fax:614-412-6944
Practice Address - Street 1:700 BRYDEN RD STE 122
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215
Practice Address - Country:US
Practice Address - Phone:614-681-0012
Practice Address - Fax:614-412-6944
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171400000X, 251B00000X
172A00000X, 172V00000X, 251S00000X
OHRZ086314347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No171400000XOther Service ProvidersHealth & Wellness Coach
No172A00000XOther Service ProvidersDriver
No172V00000XOther Service ProvidersCommunity Health Worker
No251B00000XAgenciesCase Management
No347C00000XTransportation ServicesPrivate Vehicle