Provider Demographics
NPI:1316749229
Name:CHEVALLIER, DEMIKO (RN)
Entity type:Individual
Prefix:
First Name:DEMIKO
Middle Name:
Last Name:CHEVALLIER
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 TRAYNHAM RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5145
Mailing Address - Country:US
Mailing Address - Phone:760-917-0220
Mailing Address - Fax:
Practice Address - Street 1:3626 TRAYNHAM RD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5145
Practice Address - Country:US
Practice Address - Phone:760-917-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.461011163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health