Healthcare Provider Details

I. General information

NPI: 1003787383
Provider Name (Legal Business Name): COMMUNITY CARE WOMENS HEALTH AND GYNECOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7297 GLENN HWY
CAMBRIDGE OH
43725-9034
US

IV. Provider business mailing address

7297 GLENN HWY
CAMBRIDGE OH
43725-9034
US

V. Phone/Fax

Practice location:
  • Phone: 740-435-7777
  • Fax: 866-915-7377
Mailing address:
  • Phone: 740-435-7777
  • Fax: 866-915-7377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. ERIN R BURRIS
Title or Position: OWNER
Credential: CNP
Phone: 740-435-7777