Provider Demographics
NPI:1730658964
Name:BOOTH, CHERYL ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:BOOTH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:ANN
Other - Last Name:SAVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8246
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36689-0246
Mailing Address - Country:US
Mailing Address - Phone:251-460-5461
Mailing Address - Fax:251-340-6954
Practice Address - Street 1:3719 DAUPHIN STREET
Practice Address - Street 2:BUILDING 2
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608
Practice Address - Country:US
Practice Address - Phone:251-460-5461
Practice Address - Fax:251-340-6954
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-127130163WW0000X, 363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care