Provider Demographics
NPI:1669033353
Name:ROUSSEAU, CHEYANA
Entity Type:Individual
Prefix:
First Name:CHEYANA
Middle Name:
Last Name:ROUSSEAU
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 1:4116 WEBER LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45205-1618
Mailing Address - Country:US
Mailing Address - Phone:513-258-9524
Mailing Address - Fax:
Practice Address - Street 1:4116 WEBER LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45205-1618
Practice Address - Country:US
Practice Address - Phone:513-258-9524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health