Provider Demographics
NPI:1275139040
Name:MARTIN, CHERI GAIL
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:GAIL
Last Name:MARTIN
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 1:35141 MILDRED ST # A318
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-1693
Mailing Address - Country:US
Mailing Address - Phone:440-610-8103
Mailing Address - Fax:
Practice Address - Street 1:35141 MILDRED ST # A209
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-1693
Practice Address - Country:US
Practice Address - Phone:440-610-8103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide