Provider Demographics
NPI:1659121697
Name:GRADY, CHERYL J
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:J
Last Name:GRADY
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 1:1301 14TH ST NW APT 406
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-3630
Mailing Address - Country:US
Mailing Address - Phone:202-258-1118
Mailing Address - Fax:
Practice Address - Street 1:1301 14TH ST NW APT 406
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3630
Practice Address - Country:US
Practice Address - Phone:202-258-1118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant