Provider Demographics
NPI:1073197596
Name:RIFE, CHERYL LISA
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LISA
Last Name:RIFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E REYNOLDS AVE APT A5
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-3939
Mailing Address - Country:US
Mailing Address - Phone:304-323-8955
Mailing Address - Fax:
Practice Address - Street 1:150 E REYNOLDS AVE APT A5
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-3939
Practice Address - Country:US
Practice Address - Phone:304-323-8955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant