Provider Demographics
NPI:1447222427
Name:BARGLOF, CHERYL ANN (NP)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANN
Last Name:BARGLOF
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 STREET WEST
Mailing Address - Street 2:BLDG 2669
Mailing Address - City:FORT MCCOY
Mailing Address - State:WI
Mailing Address - Zip Code:54656-0478
Mailing Address - Country:US
Mailing Address - Phone:309-781-8286
Mailing Address - Fax:
Practice Address - Street 1:11 STREET WEST
Practice Address - Street 2:BLDG 2669
Practice Address - City:FORT MCCOY
Practice Address - State:WI
Practice Address - Zip Code:54656-5017
Practice Address - Country:US
Practice Address - Phone:309-781-8286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA073977363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily