Provider Demographics
NPI:1184486524
Name:CHERRY, BRIANNE (FNP)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:CHERRY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BRIANNE
Other - Middle Name:
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:458 ASH CT
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-7510
Mailing Address - Country:US
Mailing Address - Phone:660-909-5939
Mailing Address - Fax:
Practice Address - Street 1:458 ASH CT
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-7510
Practice Address - Country:US
Practice Address - Phone:660-909-5939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024003584363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily