Provider Demographics
NPI:1417960097
Name:HOLLIFIELD, CHERYL ROSS (CNM)
Entity Type:Individual
Prefix:
First Name:CHERYL ROSS
Middle Name:
Last Name:HOLLIFIELD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7235 PROCTOR RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-9398
Mailing Address - Country:US
Mailing Address - Phone:941-366-2229
Mailing Address - Fax:941-706-1534
Practice Address - Street 1:7235 PROCTOR RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34241-9398
Practice Address - Country:US
Practice Address - Phone:941-366-2229
Practice Address - Fax:941-706-1534
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1761852367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303578600Medicaid
FL303578600Medicaid