Provider Demographics
NPI:1720796410
Name:MEDLEY, CHEYENNE A
Entity Type:Individual
Prefix:MRS
First Name:CHEYENNE
Middle Name:A
Last Name:MEDLEY
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 1:128 SLOAN AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-4340
Mailing Address - Country:US
Mailing Address - Phone:419-606-7332
Mailing Address - Fax:
Practice Address - Street 1:128 SLOAN AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4340
Practice Address - Country:US
Practice Address - Phone:419-606-7332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide