Provider Demographics
NPI:1912008251
Name:THURMAN, CHERYL G (FNP, NP-C, ARNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:G
Last Name:THURMAN
Suffix:
Gender:F
Credentials:FNP, NP-C, ARNP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:T
Other - Last Name:KLINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 950244
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0244
Mailing Address - Country:US
Mailing Address - Phone:502-953-4799
Mailing Address - Fax:502-953-4798
Practice Address - Street 1:2215 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40212-1033
Practice Address - Country:US
Practice Address - Phone:502-774-8631
Practice Address - Fax:502-996-8309
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004968363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50013766Medicaid
KY2813865000Medicaid
KY78017548Medicaid
IN200853720Medicaid
IN181540KMedicare PIN
KY0682416Medicare PIN
KYQ79430Medicare UPIN
IN200853720Medicaid
KY78017548Medicaid
KY00162057Medicare PIN