Provider Demographics
NPI:1639284250
Name:HERMAN, CHERYL A (PA-C)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:HERMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:PA
Mailing Address - Zip Code:15059-1452
Mailing Address - Country:US
Mailing Address - Phone:724-643-4852
Mailing Address - Fax:724-770-7940
Practice Address - Street 1:21 7TH ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:PA
Practice Address - Zip Code:15059-1452
Practice Address - Country:US
Practice Address - Phone:724-643-4852
Practice Address - Fax:724-643-6549
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA000128L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA015356Medicare ID - Type Unspecified
S61940Medicare UPIN