Provider Demographics
NPI:1225854656
Name:JEMISON, CIERRA ELIZABETH (CNA)
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:ELIZABETH
Last Name:JEMISON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:CIERRA
Other - Middle Name:ELIZABETH
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5102 SHANNON DR APT 209
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1556
Mailing Address - Country:US
Mailing Address - Phone:681-214-2313
Mailing Address - Fax:
Practice Address - Street 1:5102 SHANNON DR APT 209
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-1556
Practice Address - Country:US
Practice Address - Phone:681-214-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV106279376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide