Healthcare Provider Details

I. General information

NPI: 1790095073
Provider Name (Legal Business Name): LATOYA NICOLE CHERRY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LATOYA NICOLE CHERRY ARNP

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3174 NW FEDERAL HWY #3490 SUITE 302-303
JENSEN BEACH FL
34957
US

IV. Provider business mailing address

3725 SW JACK ST
PORT ST LUCIE FL
34953-3951
US

V. Phone/Fax

Practice location:
  • Phone: 772-771-9709
  • Fax: 800-860-1168
Mailing address:
  • Phone: 786-679-5825
  • Fax: 800-860-1168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN9247990
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9247990
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP9247990
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberAPRN9247990
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: