Provider Demographics
NPI:1104493832
Name:LAIRD, CHERYL JEANETTE
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:JEANETTE
Last Name:LAIRD
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 1:1821 S RIDGE RD W
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-9040
Mailing Address - Country:US
Mailing Address - Phone:440-319-2001
Mailing Address - Fax:
Practice Address - Street 1:1821 S RIDGE RD W
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-9040
Practice Address - Country:US
Practice Address - Phone:440-319-2001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker