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General NPI Number Information
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NPI Number | 1679557870
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Entity Type | Organization
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Legal Business Name | CHEROKEE FAMILY PRACTICE, INC
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 213 N 2ND ST
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City | CHEROKEE
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State | IA
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Zip | 51012-1833
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Country | US
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Telephone | 712-225-0191
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Fax | 712-225-0196
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Provider Business Mailing Address
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Address Line | 213 N 2ND ST
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City | CHEROKEE
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State | IA
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Zip | 51012-1833
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Country | US
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Telephone | 712-225-0191
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Fax | 712-225-0196
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Authorized Official
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Title or Position | OWNER
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Name | MS. JANICE ANN WOODALL
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Credential | ARNP
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Telephone | 712-225-0191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | IA
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