Provider Demographics
NPI:1952640690
Name:SUTTLES, CHERYL ELOISE (ARNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ELOISE
Last Name:SUTTLES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 INVERNESS CENTER PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4820
Mailing Address - Country:US
Mailing Address - Phone:205-684-2162
Mailing Address - Fax:844-897-5524
Practice Address - Street 1:22 INVERNESS CENTER PKWY STE 350
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-4820
Practice Address - Country:US
Practice Address - Phone:205-684-2162
Practice Address - Fax:844-897-5524
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60699815363LF0000X
AL1-114521363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-114521OtherNURSING LICENSE
WA60699815Medicaid
WA60699815Medicare Oscar/Certification
WA60699815Medicare UPIN
WA60699815Medicare PIN