Healthcare Provider Details

I. General information

NPI: 1770011983
Provider Name (Legal Business Name): CHERYL WENDY HOWARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7406 FULLERTON ST STE 200
JACKSONVILLE FL
32256-3597
US

IV. Provider business mailing address

289 GORGE RD UNIT 64
CLIFFSIDE PARK NJ
07010-8003
US

V. Phone/Fax

Practice location:
  • Phone: 904-538-0440
  • Fax: 904-538-0444
Mailing address:
  • Phone: 212-234-1412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number534105
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: