Provider Demographics
NPI:1447844337
Name:LEWIS, CHERYLE LEE (CNA)
Entity type:Individual
Prefix:
First Name:CHERYLE
Middle Name:LEE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNA
Mailing Address - Street 1:134 S 100 W APT 4
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3476
Mailing Address - Country:US
Mailing Address - Phone:951-231-3900
Mailing Address - Fax:
Practice Address - Street 1:134 S 100 W APT 4
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3476
Practice Address - Country:US
Practice Address - Phone:951-231-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT0002793811103747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000279381110OtherUNAR