Provider Demographics
NPI:1093312183
Name:STOCK, CHERYSH HUBBARD (DNP, WHNP, CNM)
Entity Type:Individual
Prefix:
First Name:CHERYSH
Middle Name:HUBBARD
Last Name:STOCK
Suffix:
Gender:F
Credentials:DNP, WHNP, CNM
Other - Prefix:
Other - First Name:CHERYSH
Other - Middle Name:FELICIA
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, WHNP, CNM
Mailing Address - Street 1:1599 W ELSIE DR
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-5208
Mailing Address - Country:US
Mailing Address - Phone:208-221-8127
Mailing Address - Fax:
Practice Address - Street 1:5121 S COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5701
Practice Address - Country:US
Practice Address - Phone:801-507-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9492401-4402207VX0000X
UT9492401-4405207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics