Provider Demographics
NPI:1831818517
Name:VANLAKE, CHERI MARIE
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:MARIE
Last Name:VANLAKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2319 BELLE GLADE CT
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-9718
Mailing Address - Country:US
Mailing Address - Phone:810-730-8073
Mailing Address - Fax:
Practice Address - Street 1:2319 BELLE GLADE CT
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-9718
Practice Address - Country:US
Practice Address - Phone:810-730-8073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide