Healthcare Provider Details

I. General information

NPI: 1326942491
Provider Name (Legal Business Name): CHERIESE TYNISHA SANDY RN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 20TH AVE S APT 1125
NASHVILLE TN
37203-6707
US

IV. Provider business mailing address

120 20TH AVE S APT 1125
NASHVILLE TN
37203-6707
US

V. Phone/Fax

Practice location:
  • Phone: 347-229-5386
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: