Provider Demographics
NPI:1851745368
Name:CHERENFANT, KETTIA CADET (NP)
Entity Type:Individual
Prefix:MRS
First Name:KETTIA
Middle Name:CADET
Last Name:CHERENFANT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5162 RISHLEY RUN WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757
Mailing Address - Country:US
Mailing Address - Phone:321-246-5358
Mailing Address - Fax:
Practice Address - Street 1:6996 PIAZZA GRANDE AVE
Practice Address - Street 2:STE 310
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-8756
Practice Address - Country:US
Practice Address - Phone:321-246-5358
Practice Address - Fax:407-880-1347
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9237369363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care