Davita Michelle Ennals, CNA

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

NA8116134 Issued in NJ

Practice address

261 Connecticut Dr
Suite 5
Burlington, NJ 08016-4177

Phone

(800) 950-6066

NPI assigned

Apr 20, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285852913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E LINCOLN AVE",
            "city": "WILDWOOD",
            "state": "NJ",
            "postal_code": "082606107",
            "telephone_number": "609-553-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 CONNECTICUT DR",
            "address_2": "SUITE 5",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080164177",
            "telephone_number": "800-950-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNALS",
        "first_name": "DAVITA",
        "middle_name": "MICHELLE",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NJ",
            "license": "NA8116134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse's Aide in Burlington, NJ
• Providers in Burlington, NJ by specialty
• Nurse's Aide in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.