Healthcare Provider Details

I. General information

NPI: 1215866827
Provider Name (Legal Business Name): CHERILEE VIRGIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29948 CARRIAGE LOOP DR
EVERGREEN CO
80439-8536
US

IV. Provider business mailing address

29948 CARRIAGE LOOP DR
EVERGREEN CO
80439-8536
US

V. Phone/Fax

Practice location:
  • Phone: 303-670-9152
  • Fax:
Mailing address:
  • Phone: 720-695-7701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberAPN.0003994-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: