Provider Demographics
NPI:1336433242
Name:HNATIUK, CHERYL B (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:B
Last Name:HNATIUK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26740 N 98TH DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-2944
Mailing Address - Country:US
Mailing Address - Phone:810-241-5459
Mailing Address - Fax:918-512-4768
Practice Address - Street 1:4840 E INDIAN SCHOOL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5500
Practice Address - Country:US
Practice Address - Phone:602-258-3696
Practice Address - Fax:602-865-8933
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3894363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN162463OtherRN
AZ2010009339OtherNP CERTIFICATION
AZ2010009339OtherNP CERTIFICATION