Provider Demographics
NPI:1598995219
Name:BURRELL-HENRY, CHERISE
Entity Type:Individual
Prefix:MRS
First Name:CHERISE
Middle Name:
Last Name:BURRELL-HENRY
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 1:4110 ALDRICH AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55412-1720
Mailing Address - Country:US
Mailing Address - Phone:612-225-7039
Mailing Address - Fax:612-588-9963
Practice Address - Street 1:4110 ALDRICH AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55412-1720
Practice Address - Country:US
Practice Address - Phone:612-225-7039
Practice Address - Fax:612-588-9963
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN344413251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health