MEDICARE: MRS. CHERISH B LEEMON CBD, CPD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula	2897	GA

General Provider Information

NPI Number	:	1639889363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERISH B LEEMON CBD, CPD

Provider Business Mailing Address
First Line	:	125 W RIVER CANE RUN
Second Line	:
City	:	PERRY
State	:	GA
Zip	:	31069-9470
Country	:	US
Telephone Number	:	850-758-1881
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 W RIVER CANE RUN
Second Line	:
City	:	PERRY
State	:	GA
Zip	:	31069-9470
Country	:	US
Telephone Number	:	850-758-1881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2022
Last Update Date	:	12/05/2022

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