Provider Demographics
NPI:1033767660
Name:FLOYD, CHERRIE TAHAMANE (RN)
Entity Type:Individual
Prefix:
First Name:CHERRIE
Middle Name:TAHAMANE
Last Name:FLOYD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30964 N GRACE LN
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-1518
Mailing Address - Country:US
Mailing Address - Phone:480-717-8883
Mailing Address - Fax:
Practice Address - Street 1:140 S GILBERT RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-1016
Practice Address - Country:US
Practice Address - Phone:480-545-2124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN076181163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse