Provider Demographics
NPI:1639889363
Name:LEEMON, CHERISH B (CBD, CPD)
Entity Type:Individual
Prefix:MRS
First Name:CHERISH
Middle Name:B
Last Name:LEEMON
Suffix:
Gender:F
Credentials:CBD, CPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W RIVER CANE RUN
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-9470
Mailing Address - Country:US
Mailing Address - Phone:850-758-1881
Mailing Address - Fax:
Practice Address - Street 1:125 W RIVER CANE RUN
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-9470
Practice Address - Country:US
Practice Address - Phone:850-758-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2897374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty