Provider Demographics
NPI:1225780661
Name:MEYER, CHERYL ANN (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANN
Last Name:MEYER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:ANN
Other - Last Name:JAEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6750 E BAYWOOD AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1749
Mailing Address - Country:US
Mailing Address - Phone:616-340-5055
Mailing Address - Fax:
Practice Address - Street 1:6750 E BAYWOOD AVE STE 301
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1749
Practice Address - Country:US
Practice Address - Phone:616-340-5055
Practice Address - Fax:480-461-4243
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704321855163W00000X
AZ283421363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ283421OtherARIZONA STATE BOARD OF NURSING
2022009329OtherAMERICAN NURSES CREDENTIALING CENTER