Provider Demographics
NPI:1437227170
Name:CHESNUT, CHERYL LYNN (FNP-C, CNM)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LYNN
Last Name:CHESNUT
Suffix:
Gender:F
Credentials:FNP-C, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:PO BOX 648
Mailing Address - Street 2:
Mailing Address - City:SWINK
Mailing Address - State:CO
Mailing Address - Zip Code:81077-0648
Mailing Address - Country:US
Mailing Address - Phone:171-938-3085
Mailing Address - Fax:171-938-3085
Practice Address - Street 1:30999 COUNTY ROAD 15
Practice Address - Street 2:
Practice Address - City:FT LYON
Practice Address - State:CO
Practice Address - Zip Code:81038
Practice Address - Country:US
Practice Address - Phone:171-945-6341
Practice Address - Fax:171-794-5635
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86182367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife