Healthcare Provider Details

I. General information

NPI: 1063822211
Provider Name (Legal Business Name): CHERE HELLENBRAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N STERLING AVE
SUGAR CREEK MO
64054-1207
US

IV. Provider business mailing address

102 N STERLING AVE
SUGAR CREEK MO
64054-1207
US

V. Phone/Fax

Practice location:
  • Phone: 816-461-3040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: