Provider Demographics
NPI:1568443398
Name:VARNER, CHERYL LYNN (MD)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LYNN
Last Name:VARNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:CHERYL
Other - Middle Name:LYNN
Other - Last Name:TAPPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1333 W 5TH ST, STE 110
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-2752
Mailing Address - Country:US
Mailing Address - Phone:307-675-4646
Mailing Address - Fax:307-675-4645
Practice Address - Street 1:1333 W 5TH ST, STE 206
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2752
Practice Address - Country:US
Practice Address - Phone:307-675-4646
Practice Address - Fax:307-675-4645
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043724207Y00000X
WY8959A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY133340200Medicaid
WA8395931Medicaid
WA8395931Medicaid
WA8803529Medicare ID - Type Unspecified