Provider Demographics
NPI:1134757263
Name:WHITE, CHERI ANGELA (PHD, ACNP-BC, CCRN)
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:ANGELA
Last Name:WHITE
Suffix:
Gender:F
Credentials:PHD, ACNP-BC, CCRN
Other - Prefix:
Other - First Name:CHERI
Other - Middle Name:ANGELA
Other - Last Name:ANNAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, RN, CCRN
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:APPLEGATE
Mailing Address - State:CA
Mailing Address - Zip Code:95703-0010
Mailing Address - Country:US
Mailing Address - Phone:530-305-4350
Mailing Address - Fax:916-781-1383
Practice Address - Street 1:1 MEDICAL PLAZA DR OFC
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3037
Practice Address - Country:US
Practice Address - Phone:916-781-1381
Practice Address - Fax:916-781-1383
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA453305363LC0200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine