Provider Demographics
NPI:1245533694
Name:CARR, CHERYL SISLER (CRNA)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:SISLER
Last Name:CARR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:28202 CABOT RD STE 105
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1247
Mailing Address - Country:US
Mailing Address - Phone:949-364-2900
Mailing Address - Fax:949-365-0117
Practice Address - Street 1:15785 LAGUNA CANYON RD STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3166
Practice Address - Country:US
Practice Address - Phone:949-364-2900
Practice Address - Fax:949-365-0117
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA3992367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered