Provider Demographics
NPI:1598701641
Name:FOSTEL, CHERYL (CFNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:FOSTEL
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:PEDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8150 N CENTRAL EXPY
Mailing Address - Street 2:SUITE M1001
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1815
Mailing Address - Country:US
Mailing Address - Phone:214-221-0022
Mailing Address - Fax:214-691-8292
Practice Address - Street 1:8150 N CENTRAL EXPY
Practice Address - Street 2:SUITE M1001
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-1815
Practice Address - Country:US
Practice Address - Phone:214-221-0022
Practice Address - Fax:214-691-8292
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222890364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
7457893OtherBLUE LINK TX
S57893Medicare UPIN
7457893OtherBLUE LINK TX