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General NPI Number Information
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NPI Number | 1245954288
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Entity Type | Individual
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Provider Name | CHERYL ANN PITOCK APRN
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Gender | Female
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1625 COMMERCE RD
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City | HOLLAND
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State | OH
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Zip | 43528-8689
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Country | US
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Telephone | 567-408-5377
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Fax | 419-273-0509
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Provider Business Mailing Address
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Address Line | 6864 GETTYSBURG DR
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City | SYLVANIA
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State | OH
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Zip | 43560-3291
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Country | US
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Telephone | 734-625-1032
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRNCNP00039350
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704368515NSA220F6
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License Number State | MI
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