Provider Demographics
NPI:1922860881
Name:OLIVER, CHAUNTIONA ANTANIA
Entity Type:Individual
Prefix:
First Name:CHAUNTIONA
Middle Name:ANTANIA
Last Name:OLIVER
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 1:5637 ANDOVER BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-3554
Mailing Address - Country:US
Mailing Address - Phone:216-769-1685
Mailing Address - Fax:
Practice Address - Street 1:5637 ANDOVER BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-3554
Practice Address - Country:US
Practice Address - Phone:216-769-1685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker