Provider Demographics
NPI:1821414830
Name:VARNER, CHERISE ANN (FAMILY NP-C)
Entity Type:Individual
Prefix:
First Name:CHERISE
Middle Name:ANN
Last Name:VARNER
Suffix:
Gender:F
Credentials:FAMILY NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-6714
Mailing Address - Country:US
Mailing Address - Phone:937-586-9733
Mailing Address - Fax:937-586-9736
Practice Address - Street 1:5 SOUTH ALEXANDERSVILLE RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3672
Practice Address - Country:US
Practice Address - Phone:937-247-0304
Practice Address - Fax:937-630-4495
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.15663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0107426Medicaid