Provider Demographics
NPI:1760898399
Name:BROPHY, CHERYL (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:BROPHY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12215 S SAGINAW ST
Mailing Address - Street 2:APT. 5
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1423
Mailing Address - Country:US
Mailing Address - Phone:810-610-7893
Mailing Address - Fax:
Practice Address - Street 1:12215 S SAGINAW ST
Practice Address - Street 2:APT 5
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1423
Practice Address - Country:US
Practice Address - Phone:810-610-7893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704180700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily