Provider Demographics
NPI:1881389641
Name:WHITE, CHEYLYNNE JOLENE
Entity type:Individual
Prefix:
First Name:CHEYLYNNE
Middle Name:JOLENE
Last Name:WHITE
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 1:4228 S INDIAN HILL RD SE
Mailing Address - Street 2:
Mailing Address - City:UHRICHSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44683-1360
Mailing Address - Country:US
Mailing Address - Phone:330-415-3677
Mailing Address - Fax:
Practice Address - Street 1:4228 S INDIAN HILL RD SE
Practice Address - Street 2:
Practice Address - City:UHRICHSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44683-1360
Practice Address - Country:US
Practice Address - Phone:330-415-3677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant