Provider Demographics
NPI:1821063264
Name:FLOM, CHERYL RENAE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:RENAE
Last Name:FLOM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 CRESTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-2115
Mailing Address - Country:US
Mailing Address - Phone:507-451-5667
Mailing Address - Fax:
Practice Address - Street 1:915 CRESTVIEW LN
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-2115
Practice Address - Country:US
Practice Address - Phone:507-451-5667
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR080023-9163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health