Provider Demographics
NPI:1487650248
Name:CHEESEMAN, KAREN M (APRN, BC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:M
Last Name:CHEESEMAN
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1943 SAYBROOK CT
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-2681
Mailing Address - Country:US
Mailing Address - Phone:770-478-5918
Mailing Address - Fax:770-478-6875
Practice Address - Street 1:1943 SAYBROOK CT
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-2681
Practice Address - Country:US
Practice Address - Phone:770-478-6091
Practice Address - Fax:770-478-6875
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN101507163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAS18482Medicare UPIN