Provider Demographics
NPI:1508459355
Name:MCLEMORE, CHEYENNE
Entity Type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:
Last Name:MCLEMORE
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 1:12898 JUNIORS DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-2844
Mailing Address - Country:US
Mailing Address - Phone:256-612-1024
Mailing Address - Fax:
Practice Address - Street 1:3401 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-5662
Practice Address - Country:US
Practice Address - Phone:205-870-1273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-12
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-175081163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics