Provider Demographics
NPI:1841865987
Name:PLASS, CHERYL MARILYN RACQUEL
Entity type:Individual
Prefix:MISS
First Name:CHERYL
Middle Name:MARILYN RACQUEL
Last Name:PLASS
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 1:4323 TORQUE ST
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-5201
Mailing Address - Country:US
Mailing Address - Phone:202-423-5896
Mailing Address - Fax:
Practice Address - Street 1:4323 TORQUE ST
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5201
Practice Address - Country:US
Practice Address - Phone:202-423-5896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCNA20211548376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide