Provider Demographics
NPI:1922196237
Name:ADAMS, CHERI M (FNP-BC, NP-C)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:M
Last Name:ADAMS
Suffix:
Gender:F
Credentials:FNP-BC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 NILES CORTLAND RD NE STE P
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1055
Mailing Address - Country:US
Mailing Address - Phone:330-856-7702
Mailing Address - Fax:330-856-1096
Practice Address - Street 1:1932 NILES CORTLAND RD NE STE P
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1055
Practice Address - Country:US
Practice Address - Phone:330-856-7702
Practice Address - Fax:330-856-1096
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP08940363LF0000X
OHNP-08940363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2711202Medicaid
000000563291OtherANTHEM
OH2711202Medicaid