Provider Demographics
NPI:1669735312
Name:CUTLIP, CHERI (AGPCNP)
Entity type:Individual
Prefix:
First Name:CHERI
Middle Name:
Last Name:CUTLIP
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6674 TIPPECANOE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9149
Mailing Address - Country:US
Mailing Address - Phone:330-533-8490
Mailing Address - Fax:
Practice Address - Street 1:6674 TIPPECANOE RD STE 1
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9149
Practice Address - Country:US
Practice Address - Phone:330-533-8490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2019-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN239947163W00000X
OHAPRN.CNP.020647363LG0600X
OHRN.239947363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology