Provider Demographics
NPI:1821797200
Name:VINZANT, CHERI LEE ANN (LVN/LPN)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:LEE ANN
Last Name:VINZANT
Suffix:
Gender:F
Credentials:LVN/LPN
Other - Prefix:
Other - First Name:CHERI
Other - Middle Name:LEE ANN
Other - Last Name:CRISP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAIDEN
Mailing Address - Street 1:1875 BUHNE DR SPC 24
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-6849
Mailing Address - Country:US
Mailing Address - Phone:530-739-0399
Mailing Address - Fax:
Practice Address - Street 1:720 WOOD ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-4413
Practice Address - Country:US
Practice Address - Phone:707-296-4771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA720211164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse