Provider Demographics
NPI:1578370227
Name:JAMES, CHERIE (CHW-C)
Entity type:Individual
Prefix:
First Name:CHERIE
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:CHW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 S BISHOP AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-4434
Mailing Address - Country:US
Mailing Address - Phone:573-308-4899
Mailing Address - Fax:
Practice Address - Street 1:1100 S BISHOP AVE STE B
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-4434
Practice Address - Country:US
Practice Address - Phone:573-308-4899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002030725164W00000X
MO2006037454183700000X
MO18953172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health Worker
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty