Healthcare Provider Details

I. General information

NPI: 1235111709
Provider Name (Legal Business Name): CHERYL M KARAM ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 03/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10418 N 45TH PL
PHOENIX AZ
85028-4234
US

IV. Provider business mailing address

10418 N 45TH PL
PHOENIX AZ
85028-4234
US

V. Phone/Fax

Practice location:
  • Phone: 602-996-9888
  • Fax:
Mailing address:
  • Phone: 602-996-9888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN034550
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: