Healthcare Provider Details

I. General information

NPI: 1124142237
Provider Name (Legal Business Name): CHERYL BARTLETT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3990 E US HIGHWAY 64 ALT
MURPHY NC
28906-6843
US

IV. Provider business mailing address

3990 E US HIGHWAY 64 ALT
MURPHY NC
28906-6843
US

V. Phone/Fax

Practice location:
  • Phone: 828-837-8161
  • Fax: 828-835-7723
Mailing address:
  • Phone: 828-837-8161
  • Fax: 828-835-7723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number074398
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: