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General NPI Number Information
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NPI Number | 1205254745
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Entity Type | Individual
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Provider Name | MARY CHERRICO RN, ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/02/2014
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Last Update Date | 04/02/2014
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Provider Practice Location Address
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Address Line | 200 HAWKINS DR. E 257 GH/ UNIVERSITY OF IOWA/CPH/PREVENTIVE INTERVENTION CENTER
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City | IOWA CITY
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State | IA
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Zip | 52252
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Country | US
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Telephone | 319-384-5030
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Fax | 319-384-5045
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Provider Business Mailing Address
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Address Line | 3100 FALCON DR NE
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-2636
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Country | US
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Telephone | 319-393-6538
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 080578
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A-080578
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License Number State | IA
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