Healthcare Provider Details

I. General information

NPI: 1447111315
Provider Name (Legal Business Name): KELLY SUE CHENEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 ELM ST
COSHOCTON OH
43812-2216
US

IV. Provider business mailing address

1311 ELM ST
COSHOCTON OH
43812-2216
US

V. Phone/Fax

Practice location:
  • Phone: 740-294-1402
  • Fax:
Mailing address:
  • Phone: 740-294-1402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: