Healthcare Provider Details

I. General information

NPI: 1487245197
Provider Name (Legal Business Name): CHERYL BOWERSOX CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL AVE
DU BOIS PA
15801-1440
US

IV. Provider business mailing address

215 BOWERSOX LN
NEW BETHLEHEM PA
16242-5005
US

V. Phone/Fax

Practice location:
  • Phone: 814-375-6470
  • Fax:
Mailing address:
  • Phone: 814-591-7955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP022966
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: