Provider Demographics
NPI:1154460715
Name:WHEELER, CHERYL DURHAM (APRN BC)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:DURHAM
Last Name:WHEELER
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:615 KNOLL DRIVE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720
Mailing Address - Country:US
Mailing Address - Phone:706-226-7446
Mailing Address - Fax:706-281-2325
Practice Address - Street 1:262 LEROY GEORGE DR
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-7430
Practice Address - Country:US
Practice Address - Phone:828-452-8110
Practice Address - Fax:828-452-8318
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN037416363L00000X
TN34556363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1154460715Medicaid
NCNC0796AMedicare PIN