Provider Demographics
NPI:1821336793
Name:IRWIN, CHERYL L (FNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:IRWIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:319 FOLLY RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2518
Practice Address - Country:US
Practice Address - Phone:843-203-2246
Practice Address - Fax:843-203-2247
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2218Medicaid
SCP01173503OtherRR-MEDICARE
SCNP2218Medicaid