Provider Demographics
NPI:1881393338
Name:KEENE, CHERYL E (HIS)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:E
Last Name:KEENE
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 JAKE ALEXANDER BLVD W
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-1365
Mailing Address - Country:US
Mailing Address - Phone:704-633-0023
Mailing Address - Fax:704-705-2363
Practice Address - Street 1:464 JAKE ALEXANDER BLVD W
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-1365
Practice Address - Country:US
Practice Address - Phone:704-633-0023
Practice Address - Fax:704-705-2363
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1392237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist