Provider Demographics
NPI:1467656561
Name:STANFORD, CHERIE (CRNP)
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:
Last Name:STANFORD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 COUNTY ROAD 1598
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:AL
Mailing Address - Zip Code:35087-2446
Mailing Address - Country:US
Mailing Address - Phone:256-796-8067
Mailing Address - Fax:
Practice Address - Street 1:15722 E LIMESTONE RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-7519
Practice Address - Country:US
Practice Address - Phone:256-262-0673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-050676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily