Provider Demographics
NPI:1174255368
Name:FLEARY-WALKER, CHENEIL (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CHENEIL
Middle Name:
Last Name:FLEARY-WALKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 CHATHAM WALK DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-2059
Mailing Address - Country:US
Mailing Address - Phone:727-265-5842
Mailing Address - Fax:
Practice Address - Street 1:311 NOLAND DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5719
Practice Address - Country:US
Practice Address - Phone:813-654-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018873363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty