Provider Demographics
NPI:1336819747
Name:DEETER, CIERRA
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:DEETER
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 1:213 W MONUMENT ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45359-9631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:213 W MONUMENT ST
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:OH
Practice Address - Zip Code:45359-9631
Practice Address - Country:US
Practice Address - Phone:937-658-2472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health