Healthcare Provider Details

I. General information

NPI: 1528122660
Provider Name (Legal Business Name): CARRON C CHERRIE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5806 11TH AVE W
BRADENTON FL
34209-3631
US

IV. Provider business mailing address

5806 11TH AVE W
BRADENTON FL
34209-3631
US

V. Phone/Fax

Practice location:
  • Phone: 941-545-0049
  • Fax:
Mailing address:
  • Phone: 941-550-0049
  • Fax: 941-201-5898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN1600632
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: