Provider Demographics
NPI:1205443207
Name:DOWDELL, CHERYL ELAINE (LPN)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ELAINE
Last Name:DOWDELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 BISCAYNE BAY CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-8671
Mailing Address - Country:US
Mailing Address - Phone:904-894-5241
Mailing Address - Fax:
Practice Address - Street 1:1685 BISCAYNE BAY CIR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-8671
Practice Address - Country:US
Practice Address - Phone:904-894-5241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5220560164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse