Provider Demographics
NPI:1861282394
Name:DAVIS, MELBA B (CNA)
Entity type:Individual
Prefix:
First Name:MELBA
Middle Name:B
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 HEMRICH DR UNIT 101
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8093
Mailing Address - Country:US
Mailing Address - Phone:614-556-1815
Mailing Address - Fax:
Practice Address - Street 1:3501 PLOWMAN PL UNIT 1013501
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-3627
Practice Address - Country:US
Practice Address - Phone:614-556-1815
Practice Address - Fax:614-556-1815
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH322379821024376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide