Provider Demographics
NPI:1245251909
Name:CODY, CHERIE KNIEPER (MSN,APRN, C-FNP)
Entity type:Individual
Prefix:MRS
First Name:CHERIE
Middle Name:KNIEPER
Last Name:CODY
Suffix:
Gender:F
Credentials:MSN,APRN, C-FNP
Other - Prefix:MS
Other - First Name:CHERIE
Other - Middle Name:ANN
Other - Last Name:KNIEPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN-BC
Mailing Address - Street 1:1320 N MORRISON BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-2242
Mailing Address - Country:US
Mailing Address - Phone:985-543-6800
Mailing Address - Fax:985-543-6801
Practice Address - Street 1:1320 N MORRISON BLVD STE 106
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-2242
Practice Address - Country:US
Practice Address - Phone:985-543-6800
Practice Address - Fax:985-543-6801
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN073486163W00000X
LAAP04596363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1456241Medicaid
Q71701Medicare UPIN
4H929Medicare ID - Type Unspecified