Provider Demographics
NPI:1417563982
Name:BEALER, CINDY LOU
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:LOU
Last Name:BEALER
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 1:1334 16TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44703-1137
Mailing Address - Country:US
Mailing Address - Phone:330-224-3929
Mailing Address - Fax:330-639-1665
Practice Address - Street 1:1334 16TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44703-1137
Practice Address - Country:US
Practice Address - Phone:133-022-4392
Practice Address - Fax:330-639-1665
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty