Provider Demographics
NPI:1528206802
Name:FORD, CHERYL LYNN
Entity Type:Individual
Prefix:MISS
First Name:CHERYL
Middle Name:LYNN
Last Name:FORD
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 1:134 DOVE LN
Mailing Address - Street 2:
Mailing Address - City:BANDERA
Mailing Address - State:TX
Mailing Address - Zip Code:78003-4182
Mailing Address - Country:US
Mailing Address - Phone:830-522-1737
Mailing Address - Fax:
Practice Address - Street 1:132 LAKE COUNTRY
Practice Address - Street 2:
Practice Address - City:LAKEHILLS
Practice Address - State:TX
Practice Address - Zip Code:78063
Practice Address - Country:US
Practice Address - Phone:830-522-1737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide