Healthcare Provider Details

I. General information

NPI: 1194619825
Provider Name (Legal Business Name): CHERYL ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 RIDDLE RD
CINCINNATI OH
45215-1041
US

IV. Provider business mailing address

10600 FORESTDALE DR
CINCINNATI OH
45240-4009
US

V. Phone/Fax

Practice location:
  • Phone: 513-570-0759
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: