Provider Demographics
NPI:1881646131
Name:SCALORA, CHERYL G (CNM)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:G
Last Name:SCALORA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 RUSSELL BLVD
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1247
Mailing Address - Country:US
Mailing Address - Phone:936-305-5277
Mailing Address - Fax:866-859-9363
Practice Address - Street 1:623 RUSSELL BLVD
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1247
Practice Address - Country:US
Practice Address - Phone:936-305-5277
Practice Address - Fax:866-859-9363
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP111647367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149852901Medicaid
TX890001003OtherRR MCR PTAN
TX80393MMedicare ID - Type Unspecified
TX149852901Medicaid
TX8G6335Medicare PIN