Provider Demographics
NPI:1740733435
Name:CAMMON WEBB, CHARONNE
Entity type:Individual
Prefix:
First Name:CHARONNE
Middle Name:
Last Name:CAMMON WEBB
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 1:1805 SAGAMORE DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-2313
Mailing Address - Country:US
Mailing Address - Phone:216-481-6609
Mailing Address - Fax:216-481-6609
Practice Address - Street 1:1805 SAGAMORE DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-2313
Practice Address - Country:US
Practice Address - Phone:216-481-6609
Practice Address - Fax:216-481-6609
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH160320164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse