Healthcare Provider Details

I. General information

NPI: 1801276795
Provider Name (Legal Business Name): CHERYL DENISE ROSS N/A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 06/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5592 FOX MEADOWS CV
MEMPHIS TN
38115-2320
US

IV. Provider business mailing address

5592 FOX MEADOWS CV
MEMPHIS TN
38115-2320
US

V. Phone/Fax

Practice location:
  • Phone: 901-800-0897
  • Fax: 901-249-7878
Mailing address:
  • Phone: 901-800-0897
  • Fax: 901-249-7878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: