Provider Demographics
NPI:1891857553
Name:DOLL, CHERYL LYNN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LYNN
Last Name:DOLL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:CHERYL
Other - Middle Name:LYNN
Other - Last Name:TYLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 341
Mailing Address - Street 2:
Mailing Address - City:COBALT
Mailing Address - State:CT
Mailing Address - Zip Code:06414-0341
Mailing Address - Country:US
Mailing Address - Phone:860-798-9255
Mailing Address - Fax:
Practice Address - Street 1:450 COLUMBUS BLVD
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06103-1801
Practice Address - Country:US
Practice Address - Phone:860-882-8673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003440363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health