Provider Demographics
NPI:1144565383
Name:SHIRLEY CHEVRY-JULES
Entity Type:Organization
Organization Name:SHIRLEY CHEVRY-JULES
Other - Org Name:SHIRLEY CHEVRY-JULES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEVRY-JULES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:614-593-9370
Mailing Address - Street 1:2595 ANNELANE BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-1961
Mailing Address - Country:US
Mailing Address - Phone:614-593-9370
Mailing Address - Fax:
Practice Address - Street 1:2595 ANNELANE BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1961
Practice Address - Country:US
Practice Address - Phone:614-593-9370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH144213302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization