MEDICARE: CHERIE H MABRY FNP

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
1	363L00000X	Nurse Practitioner	31208	SC

General Provider Information

NPI Number	:	1518821594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERIE H MABRY FNP

Provider Business Mailing Address
First Line	:	840 RIDGE RD
Second Line	:
City	:	EASLEY
State	:	SC
Zip	:	29642-9624
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	840 RIDGE RD
Second Line	:
City	:	EASLEY
State	:	SC
Zip	:	29642-9624
Country	:	US
Telephone Number	:	864-356-2241
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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