MEDICARE: CHERYL CZERNEY NP

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	363LP0200X	Pediatric Nurse Practitioner	4704123552	MI

General Provider Information

NPI Number	:	1932177169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL CZERNEY NP

Provider Business Mailing Address
First Line	:	100 VAN BUREN ST W
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49017-3050
Country	:	US
Telephone Number	:	269-965-9539
Fax Number	:

Provider Business Practice Location Address
First Line	:	9979 WILDWOOD DR
Second Line	:
City	:	RICHLAND
State	:	MI
Zip	:	49083-8524
Country	:	US
Telephone Number	:	269-629-9808
Fax Number	:

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/08/2007

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