Provider Demographics
NPI:1376728428
Name:ANDRESS, CHERYL JEAN (RN)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:JEAN
Last Name:ANDRESS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1741
Mailing Address - Street 2:
Mailing Address - City:HIGLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85236-1741
Mailing Address - Country:US
Mailing Address - Phone:480-703-1143
Mailing Address - Fax:480-988-9021
Practice Address - Street 1:16445 S 164TH ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-2005
Practice Address - Country:US
Practice Address - Phone:480-703-1143
Practice Address - Fax:480-988-9021
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN053179163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice