Individual ProviderKassandra DavisRegistered NurseNursing Service ProvidersPractice Address3564 Eastchester Rd, Bronx, NY 10469-1658(347) 274-5659PECOS EnrollmentBased on the most recent information from CMS, provider Kassandra 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 7 days ago.Profile DetailsProvider ID1518400357Provider TypeIndividualFull NameDavis, KassandraCredentialLPNGenderFemaleSole ProprietorYesEnumeration Date11/28/2016Last Updated12/7/2023Contact InformationPractice LocationPractice Address3564 Eastchester Rd, Bronx, NY 10469-1658Phone(347) 274-5659FaxUnlisted FaxMailing LocationMailing Address3564 Eastchester Rd, Bronx, NY 10469-1658PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense914554New YorkCode164W00000XDescriptionLicensed Practical NurseNursing Service ProvidersLicense302880New York