Provider Demographics
NPI:1033378096
Name:MONSOUR, CHERYL ANNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANNE
Last Name:MONSOUR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:ANNE
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:347 GOLF DR SE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44403
Mailing Address - Country:US
Mailing Address - Phone:330-448-1451
Mailing Address - Fax:
Practice Address - Street 1:347 GOLF DR SE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:OH
Practice Address - Zip Code:44403
Practice Address - Country:US
Practice Address - Phone:330-448-1451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN044422251E00000X
PAPN051156L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health