Provider Demographics
NPI:1750149621
Name:JENNINGS, CHERYL
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:
Last Name:JENNINGS
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 1:7915 W MISSY PL
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34433-4413
Mailing Address - Country:US
Mailing Address - Phone:267-229-2229
Mailing Address - Fax:
Practice Address - Street 1:7915 W MISSY PL
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34433-4413
Practice Address - Country:US
Practice Address - Phone:267-229-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider