Provider Demographics
NPI:1902201213
Name:DUVAL, CHERYL (RN, HEALTH EDUCATOR)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:DUVAL
Suffix:
Gender:F
Credentials:RN, HEALTH EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WARSAW AVE
Mailing Address - Street 2:
Mailing Address - City:DUDLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01571-3418
Mailing Address - Country:US
Mailing Address - Phone:508-335-1614
Mailing Address - Fax:
Practice Address - Street 1:17 WARSAW AVE
Practice Address - Street 2:
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571-3418
Practice Address - Country:US
Practice Address - Phone:508-335-1614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN174741174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator