Provider Demographics
NPI:1770710428
Name:HARRIS, CHERYL ANNE (CNA)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANNE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54617 CHALMERS DR
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46561-8731
Mailing Address - Country:US
Mailing Address - Phone:574-674-5752
Mailing Address - Fax:
Practice Address - Street 1:54617 CHALMERS DR
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IN
Practice Address - Zip Code:46561-8731
Practice Address - Country:US
Practice Address - Phone:574-674-5752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INCNA0903819376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide