Provider Demographics
NPI:1942953062
Name:CHITWOOD, YULONDA J
Entity Type:Individual
Prefix:
First Name:YULONDA
Middle Name:J
Last Name:CHITWOOD
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 1:1834 MONTICELLO AVE NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44485-2145
Mailing Address - Country:US
Mailing Address - Phone:330-978-2722
Mailing Address - Fax:
Practice Address - Street 1:17792 REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:WEST FARMINGTON
Practice Address - State:OH
Practice Address - Zip Code:44491-9618
Practice Address - Country:US
Practice Address - Phone:440-749-1098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH258907163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse