Healthcare Provider Details

I. General information

NPI: 1952647851
Provider Name (Legal Business Name): CHERYSH KEMP GUNKLE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2012
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 1ST ST W STE H
SONOMA CA
95476-7046
US

IV. Provider business mailing address

651 1ST ST W STE H
SONOMA CA
95476-7046
US

V. Phone/Fax

Practice location:
  • Phone: 707-938-3870
  • Fax: 707-938-3895
Mailing address:
  • Phone: 707-938-3870
  • Fax: 707-938-3895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95009228
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5006004
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: