Provider Demographics
NPI:1821865429
Name:RUNYON, CHERYLL (CHWC)
Entity Type:Individual
Prefix:
First Name:CHERYLL
Middle Name:
Last Name:RUNYON
Suffix:
Gender:F
Credentials:CHWC
Other - Prefix:
Other - First Name:CHERYLL
Other - Middle Name:
Other - Last Name:RUNYON BALLESTEROS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CHWC
Mailing Address - Street 1:2016 E GARRISON ST # 19
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-5068
Mailing Address - Country:US
Mailing Address - Phone:915-228-0871
Mailing Address - Fax:
Practice Address - Street 1:2016 E GARRISON ST # 19
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-5068
Practice Address - Country:US
Practice Address - Phone:915-228-0871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach