Provider Demographics
NPI:1083127013
Name:CHERESON, MICHELE ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:CHERESON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3822 COLONIAL AVE STE C
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-3826
Mailing Address - Country:US
Mailing Address - Phone:814-616-0321
Mailing Address - Fax:814-528-5643
Practice Address - Street 1:3822 COLONIAL AVE STE C
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-3826
Practice Address - Country:US
Practice Address - Phone:814-616-0321
Practice Address - Fax:814-528-5643
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018093363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner