Provider Demographics
NPI:1699020263
Name:MCDONALD, CHERYL LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 LINDENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-7639
Mailing Address - Country:US
Mailing Address - Phone:727-514-3527
Mailing Address - Fax:727-940-7572
Practice Address - Street 1:1317 LINDENWOOD DR
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34688-7639
Practice Address - Country:US
Practice Address - Phone:256-299-5110
Practice Address - Fax:727-940-7572
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP893472363L00000X
FLAPRN89347363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGM824ZMedicare PIN