Provider Demographics
NPI:1629770342
Name:SIMONS, CHERYL ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ELIZABETH
Last Name:SIMONS
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 1:6780 FARMINGDALE LN
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-3990
Mailing Address - Country:US
Mailing Address - Phone:440-487-6116
Mailing Address - Fax:
Practice Address - Street 1:6780 FARMINGDALE LN
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-3990
Practice Address - Country:US
Practice Address - Phone:440-487-6116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRS847180376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker