Provider Demographics
NPI:1306238613
Name:SADDLER, CHERYL (CNA)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:SADDLER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 MOUNTAINVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-7167
Mailing Address - Country:US
Mailing Address - Phone:843-505-1802
Mailing Address - Fax:
Practice Address - Street 1:130 MOUNTAINVIEW DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-7167
Practice Address - Country:US
Practice Address - Phone:843-505-1802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-23
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
GACN0014201985376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide