Provider Demographics
NPI:1811246630
Name:CHERRY, OLEAN ROSHONDA
Entity type:Individual
Prefix:MS
First Name:OLEAN
Middle Name:ROSHONDA
Last Name:CHERRY
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 1:2620 WESTMAR CT
Mailing Address - Street 2:APT 156
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-2053
Mailing Address - Country:US
Mailing Address - Phone:419-297-9806
Mailing Address - Fax:
Practice Address - Street 1:2620 WESTMAR CT
Practice Address - Street 2:APT 156
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-2053
Practice Address - Country:US
Practice Address - Phone:419-297-9806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion