Healthcare Provider Details

I. General information

NPI: 1427207554
Provider Name (Legal Business Name): CHERYL DENISE HUNTER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2008
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2866 E WATER ST
ROCK CREEK OH
44084-9527
US

IV. Provider business mailing address

2866 E WATER ST
ROCK CREEK OH
44084-9527
US

V. Phone/Fax

Practice location:
  • Phone: 440-563-6976
  • Fax: 440-563-3023
Mailing address:
  • Phone: 440-563-6976
  • Fax: 440-563-3023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number130814
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: