Provider Demographics
NPI:1275181471
Name:CHERRY, HATTIE LYNNETTE
Entity Type:Individual
Prefix:
First Name:HATTIE
Middle Name:LYNNETTE
Last Name:CHERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2539 SHELBURNE PL
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-8527
Mailing Address - Country:US
Mailing Address - Phone:704-506-4677
Mailing Address - Fax:980-406-3226
Practice Address - Street 1:2539 SHELBURNE PL
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-8527
Practice Address - Country:US
Practice Address - Phone:704-506-4677
Practice Address - Fax:980-406-3226
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider