Provider Demographics
NPI:1295505626
Name:MACDONALD, CHERYL LYNNE (RN)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNNE
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 CARVER ST
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:MA
Mailing Address - Zip Code:02338-1718
Mailing Address - Country:US
Mailing Address - Phone:781-844-7458
Mailing Address - Fax:
Practice Address - Street 1:71 CARVER ST
Practice Address - Street 2:
Practice Address - City:HALIFAX
Practice Address - State:MA
Practice Address - Zip Code:02338-1718
Practice Address - Country:US
Practice Address - Phone:781-844-7458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2258833163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health