Individual ProviderKenyghatta DavisCase Manager/Care CoordinatorOther Service ProvidersPractice Address1510 Byrum Rd, Blytheville, AR 72315-8033(870) 532-2600(870) 763-2841PECOS EnrollmentBased on the most recent information from CMS, provider Kenyghatta Davis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1164639480Provider TypeIndividualFull NameDavis, KenyghattaCredentialMHPPGenderFemaleSole ProprietorYesEnumeration Date5/17/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address1510 Byrum Rd, Blytheville, AR 72315-8033Phone(870) 532-2600FaxUnlisted FaxMailing LocationMailing Address812 Clark St, Blytheville, AR 72315-4508Phone(870) 763-2841FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer