Provider Demographics
NPI:1699499780
Name:CHEEKS, STEPHANIE KEYANNA (GRADUATE NURSE)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KEYANNA
Last Name:CHEEKS
Suffix:
Gender:F
Credentials:GRADUATE NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 W 7TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-1333
Mailing Address - Country:US
Mailing Address - Phone:267-978-7861
Mailing Address - Fax:
Practice Address - Street 1:524 ARBOR RD
Practice Address - Street 2:
Practice Address - City:YEADON
Practice Address - State:PA
Practice Address - Zip Code:19050-3206
Practice Address - Country:US
Practice Address - Phone:267-978-7861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA99859624376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty