Provider Demographics
NPI:1821367384
Name:COVENEY, CHERYLE (NP)
Entity Type:Individual
Prefix:
First Name:CHERYLE
Middle Name:
Last Name:COVENEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHERYLE
Other - Middle Name:
Other - Last Name:CLINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 664056
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46266-4056
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:1030 E COUNTY LINE RD
Practice Address - Street 2:B-2
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-2932
Practice Address - Country:US
Practice Address - Phone:317-887-6060
Practice Address - Fax:317-859-5944
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002777A363L00000X, 364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner