MEDICARE: DR. CARRON C CHERRIE APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN1600632	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	197552	OTHER	FL	PROVIDER NUMBER

General Provider Information

NPI Number	:	1528122660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARRON C CHERRIE APRN

Provider Business Mailing Address
First Line	:	5806 11TH AVE W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-3631
Country	:	US
Telephone Number	:	941-550-0049
Fax Number	:	941-201-5898

Provider Business Practice Location Address
First Line	:	5806 11TH AVE W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-3631
Country	:	US
Telephone Number	:	941-545-0049
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	12/15/2025

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