Healthcare Provider Details

I. General information

NPI: 1588972954
Provider Name (Legal Business Name): CHERYL LYN ZDANA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32711 LONG NECK RD
MILLSBORO DE
19966-6678
US

IV. Provider business mailing address

PO BOX 4110
WOBURN MA
01888-4110
US

V. Phone/Fax

Practice location:
  • Phone: 302-945-9730
  • Fax: 302-945-9732
Mailing address:
  • Phone: 302-945-9730
  • Fax: 302-945-9732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2009011267
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberL10020701
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: