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NPI Code Detail

MEDICARE: MRS. CHERYL MOELLER

MEDICARE: MRS. CHERYL MOELLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorOH1228965OH

General Provider Information

NPI Number : 1992116214
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHERYL MOELLER
Provider Business Mailing Address
First Line : 4588 STONEHAVEN DR
Second Line :
City : LIBERTY TWP
State : OH
Zip : 45011-6602
Country : US
Telephone Number : 513-887-5035
Fax Number :
Provider Business Practice Location Address
First Line : 250 N FAIR AVE
Second Line :
City : HAMILTON
State : OH
Zip : 45011-4222
Country : US
Telephone Number : 513-887-5035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2014
Last Update Date : 05/09/2014

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Directions to “ MRS. CHERYL MOELLER ” Practice Location

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