Provider Demographics
NPI:1194196295
Name:SMITH, CHERIE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHERIE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1184 CLEAVER RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-1143
Mailing Address - Country:US
Mailing Address - Phone:888-758-5709
Mailing Address - Fax:
Practice Address - Street 1:1184 CLEAVER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-1143
Practice Address - Country:US
Practice Address - Phone:888-758-5709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704177420363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily