Provider Demographics
NPI:1275623704
Name:ASHBROOK, CHERYL EILEEN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:EILEEN
Last Name:ASHBROOK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 COUNTY ROAD 995
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-9411
Mailing Address - Country:US
Mailing Address - Phone:419-496-2487
Mailing Address - Fax:
Practice Address - Street 1:1513 COUNTY ROAD 995
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-9411
Practice Address - Country:US
Practice Address - Phone:419-496-2487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN095018MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse