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NPI Code Detail

MEDICARE: MS. CAROL LYNN CHERRY

MEDICARE:  MS. CAROL LYNN CHERRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner814745NV

General Provider Information

NPI Number : 1366923096
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROL LYNN CHERRY
Provider Business Mailing Address
First Line : 6465 W SAHARA AVE
Second Line : STE 103
City : LAS VEGAS
State : NV
Zip : 89146-3071
Country : US
Telephone Number : 702-684-7800
Fax Number :
Provider Business Practice Location Address
First Line : 6465 W SAHARA AVE STE 103
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3071
Country : US
Telephone Number : 702-822-1881
Fax Number : 702-822-1880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2018
Last Update Date : 05/17/2021

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Directions to “ MS. CAROL LYNN CHERRY ” Practice Location

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