Provider Demographics
NPI:1235595182
Name:PEOPLES, CHARLENE
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:
Last Name:PEOPLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:STNA
Mailing Address - Street 1:35599 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:OH
Mailing Address - Zip Code:45634-8717
Mailing Address - Country:US
Mailing Address - Phone:740-577-8203
Mailing Address - Fax:740-596-2632
Practice Address - Street 1:35599 LAKEVIEW RD
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:OH
Practice Address - Zip Code:45634-8717
Practice Address - Country:US
Practice Address - Phone:740-577-8203
Practice Address - Fax:740-596-2632
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide