Susan Dianne Cheatwood, LPN

Individual provider Active NPI Licensed Practical Nurse · Jacksonville, AL

NPI 1346561545 · NPPES record last updated Jun 22, 2010

Key facts

NPI
1346561545
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
2039828 (AL)
Practice address
1701 Pelham Rd S Ste B
Jacksonville, AL 36265-3372
Phone
(256) 782-4256
Fax
(256) 782-4242
NPI assigned
Jun 22, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2039828ALMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2039828 AL Yes

Addresses

Primary practice location

1701 Pelham Rd S Ste B
Jacksonville, AL 36265-3372

Mailing address

713 Oak St
Anniston, AL 36207-4766
Phone (256) 591-5873

Other providers in Jacksonville, AL

All providers in Jacksonville, AL · Licensed Practical Nurse in Alabama

Sources for this page

Verify at the official NPI Registry.