Provider Demographics
NPI:1194354860
Name:EALY, CHLOE E
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:E
Last Name:EALY
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 1:233 BANNOCK DR
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-5056
Mailing Address - Country:US
Mailing Address - Phone:513-649-6956
Mailing Address - Fax:
Practice Address - Street 1:233 BANNOCK DR
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-5056
Practice Address - Country:US
Practice Address - Phone:513-649-6956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-05
Last Update Date:2020-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide