Provider Demographics
NPI:1891459434
Name:STRONG, CHERONNA A
Entity Type:Individual
Prefix:
First Name:CHERONNA
Middle Name:A
Last Name:STRONG
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 1:835 BENT CREEK DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-1293
Mailing Address - Country:US
Mailing Address - Phone:980-322-4873
Mailing Address - Fax:
Practice Address - Street 1:835 BENT CREEK DR UNIT 102
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-1293
Practice Address - Country:US
Practice Address - Phone:980-322-4873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC295383376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty