Healthcare Provider Details

I. General information

NPI: 1992716245
Provider Name (Legal Business Name): CHERYL A. COVERT MS, RN, CS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 SAINT JOHNS BAY
WOODBURY MN
55129-8537
US

IV. Provider business mailing address

1044 SAINT JOHNS BAY
WOODBURY MN
55129-8537
US

V. Phone/Fax

Practice location:
  • Phone: 651-592-8348
  • Fax:
Mailing address:
  • Phone: 651-592-8348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number0072119
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: