Provider Demographics
NPI:1003031311
Name:CHERRY, NANCY S
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:S
Last Name:CHERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 JUNIPER DR
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-1428
Mailing Address - Country:US
Mailing Address - Phone:812-523-3323
Mailing Address - Fax:812-523-3323
Practice Address - Street 1:822 JUNIPER DR
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-1428
Practice Address - Country:US
Practice Address - Phone:812-523-3323
Practice Address - Fax:812-523-3323
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22002893235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist