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General NPI Number Information
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NPI Number | 1578347050
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Entity Type | Individual
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Provider Name | JUSTIN CHEREPY APRN-FNP
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Gender | Male
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 1000 CLYBURN PL
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City | AIKEN
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State | SC
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Zip | 29801-4193
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Country | US
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Telephone | 803-593-9283
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Fax |
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Provider Business Mailing Address
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Address Line | 303 DOVE LAKE DR
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-7621
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Country | US
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Telephone | 561-339-4479
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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 | APN.27545
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License Number State | SC
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