Provider Demographics
NPI:1245531755
Name:WILLIAMS-BALLARD, CHERYL RENEE
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:RENEE
Last Name:WILLIAMS-BALLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:RENEE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:1714 BRIGHTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-2305
Mailing Address - Country:US
Mailing Address - Phone:513-315-4856
Mailing Address - Fax:
Practice Address - Street 1:1714 BRIGHTVIEW DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-2305
Practice Address - Country:US
Practice Address - Phone:513-315-4856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-089824164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse