Individual
CHEYENNE SUMMERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CERTIFIED COMMUNITY
Contact information
Practice address
120 PENN ST, BALTIMORE, MD 21201-1082
(410) 706-2501
(410) 328-3379
Mailing address
250 W PRATT ST STE 880, BALTIMORE, MD 21201-6829
(667) 214-1301
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
01115-22-A
MD
Other
Enumeration date
04/02/2024
Last updated
05/06/2024
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