Provider Demographics
NPI:1467213728
Name:PENDLETON, CHRISTLE
Entity Type:Individual
Prefix:
First Name:CHRISTLE
Middle Name:
Last Name:PENDLETON
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 1:2176 E 43RD ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-4414
Mailing Address - Country:US
Mailing Address - Phone:216-309-7382
Mailing Address - Fax:
Practice Address - Street 1:2176 E 43RD ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-4414
Practice Address - Country:US
Practice Address - Phone:216-309-7382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide