Provider Demographics
NPI:1578525770
Name:HIROS, CHERYL RUTH (CRNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:RUTH
Last Name:HIROS
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 1:1022 1ST ST N
Mailing Address - Street 2:SUITE 400B
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8706
Mailing Address - Country:US
Mailing Address - Phone:205-621-4799
Mailing Address - Fax:205-620-1767
Practice Address - Street 1:1022 1ST ST N
Practice Address - Street 2:SUITE 400B
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8706
Practice Address - Country:US
Practice Address - Phone:205-621-4799
Practice Address - Fax:205-620-1767
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11058245363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051552714Medicaid
AL051552714Medicaid
ALS56050Medicare UPIN