Provider Demographics
NPI:1922003938
Name:REEDUS, CHERYL DENISE (APRN-BC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:DENISE
Last Name:REEDUS
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:DENISE
Other - Last Name:DEBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:275 COLLIER RD NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1709
Mailing Address - Country:US
Mailing Address - Phone:404-355-9815
Mailing Address - Fax:404-350-0529
Practice Address - Street 1:275 COLLIER RD NW
Practice Address - Street 2:SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1709
Practice Address - Country:US
Practice Address - Phone:404-355-9815
Practice Address - Fax:404-350-0529
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA063216363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA838108869BMedicaid
GA838108869AMedicaid
GA50BBGTQMedicare PIN