MEDICARE: MRS. LATOYA NICOLE CHERRY ARNP

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	363LA2100X	Acute Care Nurse Practitioner	APRN9247990	FL
2	363LF0000X	Family Nurse Practitioner	ARNP9247990	FL
3	363LG0600X	Gerontology Nurse Practitioner	ARNP9247990	FL
4	163WW0000X	Wound Care Registered Nurse	APRN9247990	FL

General Provider Information

NPI Number	:	1790095073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LATOYA NICOLE CHERRY ARNP

Provider Business Mailing Address
First Line	:	3725 SW JACK ST
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34953-3951
Country	:	US
Telephone Number	:	786-679-5825
Fax Number	:	800-860-1168

Provider Business Practice Location Address
First Line	:	3174 NW FEDERAL HWY #3490
Second Line	:	SUITE 302-303
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957
Country	:	US
Telephone Number	:	772-771-9709
Fax Number	:	800-860-1168

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

Provider Enumeration Date	:	10/20/2010
Last Update Date	:	08/05/2024

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