Provider Demographics
NPI:1831482967
Name:SAVAGE, CHERYL ANTIONETTE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANTIONETTE
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5429 PRICE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-4532
Mailing Address - Country:US
Mailing Address - Phone:443-742-3078
Mailing Address - Fax:
Practice Address - Street 1:5429 PRICE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-4532
Practice Address - Country:US
Practice Address - Phone:443-742-3078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR111683163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse