Provider Demographics
NPI:1265201339
Name:ROBERTS, CHERYL LYNN (RN)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9165 PROMISING CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0479
Mailing Address - Country:US
Mailing Address - Phone:702-506-7211
Mailing Address - Fax:
Practice Address - Street 1:4040 S EASTERN AVE STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0854
Practice Address - Country:US
Practice Address - Phone:702-463-0300
Practice Address - Fax:702-463-0301
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN36769163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management