Provider Demographics
NPI:1588267900
Name:ROBERTS, CHERYL ANN
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:ROBERTS
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 1:247 SCHOLL RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-4674
Mailing Address - Country:US
Mailing Address - Phone:937-609-7664
Mailing Address - Fax:
Practice Address - Street 1:247 SCHOLL RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-4674
Practice Address - Country:US
Practice Address - Phone:937-609-7664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2883616251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health