Provider Demographics
NPI:1376730754
Name:DENTON, CHERYL L
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:L
Last Name:DENTON
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 1:3325 LIBERTY CT
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-6489
Mailing Address - Country:US
Mailing Address - Phone:907-488-1446
Mailing Address - Fax:
Practice Address - Street 1:3325 LIBERTY CT
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-6489
Practice Address - Country:US
Practice Address - Phone:907-488-1446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4714164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse