Provider Demographics
NPI:1518148931
Name:ARDREY, CECILE I (RN)
Entity Type:Individual
Prefix:MRS
First Name:CECILE
Middle Name:I
Last Name:ARDREY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7066 STAGECOACH RD NW
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43150-9609
Mailing Address - Country:US
Mailing Address - Phone:740-215-7699
Mailing Address - Fax:740-743-9338
Practice Address - Street 1:7066 STAGECOACH RD NW
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:OH
Practice Address - Zip Code:43150-9609
Practice Address - Country:US
Practice Address - Phone:740-215-7699
Practice Address - Fax:740-743-9338
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2008-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN337583163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2777491Medicaid