Provider Demographics
NPI:1043880552
Name:CHERRY, LATOYA DANIELLE
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:DANIELLE
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 1:3317 PERKINS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6063
Mailing Address - Country:US
Mailing Address - Phone:919-909-4360
Mailing Address - Fax:
Practice Address - Street 1:3317 PERKINS RIDGE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-6063
Practice Address - Country:US
Practice Address - Phone:919-909-4360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver