Provider Demographics
NPI:1508397829
Name:CHERUIYOT, IRENE (APRN)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:CHERUIYOT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 CENTER PARK DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1825
Mailing Address - Country:US
Mailing Address - Phone:859-445-8406
Mailing Address - Fax:
Practice Address - Street 1:316 CENTER PARK DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1825
Practice Address - Country:US
Practice Address - Phone:859-445-8406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4021976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily