Provider Demographics
NPI:1689914723
Name:HENRY-SMITH, CHERYL ANNE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANNE
Last Name:HENRY-SMITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 GENDARME RD
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-5104
Mailing Address - Country:US
Mailing Address - Phone:337-534-4093
Mailing Address - Fax:337-534-4087
Practice Address - Street 1:114 REPRESENTATIVE ROW STE B
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3878
Practice Address - Country:US
Practice Address - Phone:337-412-6555
Practice Address - Fax:337-456-2792
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07198363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health