MEDICARE: CHERYL MCDUFFIE FNP-C

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	363LF0000X	Family Nurse Practitioner	AP123495	TX

General Provider Information

NPI Number	:	1831587336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL MCDUFFIE FNP-C

Provider Business Mailing Address
First Line	:	9 GREENWAY PLZ STE 2950
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77046-0924
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 GREENWAY PLZ STE 2950
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77046-0924
Country	:	US
Telephone Number	:	713-580-9482
Fax Number	:

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

Provider Enumeration Date	:	01/06/2015
Last Update Date	:	01/06/2015

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