Provider Demographics
NPI:1356834725
Name:HASCH, CHERYL LEIGH (ARNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LEIGH
Last Name:HASCH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1696 W HIBISCUS BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-2638
Mailing Address - Country:US
Mailing Address - Phone:321-802-2679
Mailing Address - Fax:800-479-0898
Practice Address - Street 1:1008 ESSEN AVE NW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-8281
Practice Address - Country:US
Practice Address - Phone:321-442-1395
Practice Address - Fax:800-479-0898
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3100132363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily