Provider Demographics
NPI:1073379301
Name:CHERRY, CHRISTINA DIANE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:DIANE
Last Name:CHERRY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 DELAMERE CT
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-4184
Mailing Address - Country:US
Mailing Address - Phone:614-915-2049
Mailing Address - Fax:
Practice Address - Street 1:477 COOPER RD STE 320
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-6045
Practice Address - Country:US
Practice Address - Phone:380-201-3390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0035874363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health