Provider Demographics
NPI:1386349850
Name:CARDWELL, CHAYNA JUSTICE
Entity type:Individual
Prefix:
First Name:CHAYNA
Middle Name:JUSTICE
Last Name:CARDWELL
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 1:70516 RADCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:WILKESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45695-8900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70516 RADCLIFF RD
Practice Address - Street 2:
Practice Address - City:WILKESVILLE
Practice Address - State:OH
Practice Address - Zip Code:45695-8900
Practice Address - Country:US
Practice Address - Phone:740-612-9780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant