Provider Demographics
NPI:1578921102
Name:MAYS, CHERITY GWEN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHERITY
Middle Name:GWEN
Last Name:MAYS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:CHERITY
Other - Middle Name:GWEN
Other - Last Name:FAZIOLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2501 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1531
Mailing Address - Country:US
Mailing Address - Phone:806-358-9400
Mailing Address - Fax:
Practice Address - Street 1:2501 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1531
Practice Address - Country:US
Practice Address - Phone:806-358-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200733380AMedicaid
TX376180101Medicaid
NM89730054Medicaid