Provider Demographics
NPI:1518517457
Name:CHERRY, CHIAKI
Entity Type:Individual
Prefix:MRS
First Name:CHIAKI
Middle Name:
Last Name:CHERRY
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:P.O. BOX 23413
Mailing Address - Street 2:
Mailing Address - City:BARRIGADA
Mailing Address - State:GU
Mailing Address - Zip Code:96921
Mailing Address - Country:US
Mailing Address - Phone:671-789-1011
Mailing Address - Fax:
Practice Address - Street 1:175 JUAQUIN AGUON RD.
Practice Address - Street 2:
Practice Address - City:YONA
Practice Address - State:GU
Practice Address - Zip Code:96915
Practice Address - Country:US
Practice Address - Phone:808-433-7852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider