Provider Demographics
NPI:1932144367
Name:CHEATHAM, LAQUITA T (MSN NP)
Entity Type:Individual
Prefix:
First Name:LAQUITA
Middle Name:T
Last Name:CHEATHAM
Suffix:
Gender:F
Credentials:MSN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7021 WESTBELT DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-1023
Mailing Address - Country:US
Mailing Address - Phone:615-350-4805
Mailing Address - Fax:615-350-4861
Practice Address - Street 1:7021 WESTBELT DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-1023
Practice Address - Country:US
Practice Address - Phone:615-350-4805
Practice Address - Fax:615-350-4861
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN6269363LA2200X
TNRN77469163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ006235Medicaid
TNP81242Medicare UPIN