Provider Demographics
NPI:1225752231
Name:CHERRY, CHARLOTTE RENA (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:RENA
Last Name:CHERRY
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W KAY ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TX
Mailing Address - Zip Code:77535-2256
Mailing Address - Country:US
Mailing Address - Phone:254-217-9952
Mailing Address - Fax:
Practice Address - Street 1:14141 SOUTHWEST FWY STE 500
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3494
Practice Address - Country:US
Practice Address - Phone:281-356-0364
Practice Address - Fax:833-711-1699
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1095780363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily