Provider Demographics
NPI:1063806545
Name:CHAVERS, NEKISHA C (LPN)
Entity type:Individual
Prefix:
First Name:NEKISHA
Middle Name:C
Last Name:CHAVERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 BEVERLY AVE NE APT 10
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721
Mailing Address - Country:US
Mailing Address - Phone:330-915-0485
Mailing Address - Fax:
Practice Address - Street 1:7300 BEVERLY AVE NE APT 10
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-2053
Practice Address - Country:US
Practice Address - Phone:330-915-0485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH157540164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse