Healthcare Provider Details

I. General information

NPI: 1982022836
Provider Name (Legal Business Name): CHRISTINA CHERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 WAZEE ST STE 1A
DENVER CO
80202-1476
US

IV. Provider business mailing address

3612 ASPEN DR
SCOTTSBLUFF NE
69361-1896
US

V. Phone/Fax

Practice location:
  • Phone: 719-838-4914
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35259
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: