Provider Demographics
NPI:1619333895
Name:VASSELL, CHERE (RN, MSN)
Entity Type:Individual
Prefix:
First Name:CHERE
Middle Name:
Last Name:VASSELL
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3216 MURRAY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2254
Mailing Address - Country:US
Mailing Address - Phone:757-941-7688
Mailing Address - Fax:
Practice Address - Street 1:3216 MURRAY RIDGE RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2254
Practice Address - Country:US
Practice Address - Phone:757-941-7688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95063367163W00000X
VA0001196283163W00000X
FLRN9317859163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse