Provider Demographics
NPI:1447574348
Name:ABERNATHY, CHERYL M (NNP-BC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:M
Last Name:ABERNATHY
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3532 VICTORIA STA
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-8448
Mailing Address - Country:US
Mailing Address - Phone:810-257-9181
Mailing Address - Fax:
Practice Address - Street 1:3532 VICTORIA STA
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-8448
Practice Address - Country:US
Practice Address - Phone:810-257-9181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704232354363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care