Provider Demographics
NPI:1023384062
Name:JESPERSEN, CHERI MAUREEN (WHCNP)
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:MAUREEN
Last Name:JESPERSEN
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:CHERI
Other - Middle Name:MAUREEN
Other - Last Name:MONTEITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:826 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-6012
Mailing Address - Country:US
Mailing Address - Phone:541-887-8229
Mailing Address - Fax:541-887-8235
Practice Address - Street 1:826 MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-6012
Practice Address - Country:US
Practice Address - Phone:541-887-8229
Practice Address - Fax:541-887-8235
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201250034NP363L00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner