Provider Demographics
NPI:1497586820
Name:CREMEANS, DESTINEE
Entity type:Individual
Prefix:
First Name:DESTINEE
Middle Name:
Last Name:CREMEANS
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 1:2589 TOWNSHIP ROAD 177
Mailing Address - Street 2:
Mailing Address - City:WILLOW WOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45696-9057
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2609 TOWNSHIP ROAD 177
Practice Address - Street 2:
Practice Address - City:WILLOW WOOD
Practice Address - State:OH
Practice Address - Zip Code:45696-9057
Practice Address - Country:US
Practice Address - Phone:740-547-4474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant