Provider Demographics
NPI:1770912800
Name:GEORGE, CHERYL LEE (FNP)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LEE
Last Name:GEORGE
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:8170 LAGUNA BLVD STE 220
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7902
Practice Address - Country:US
Practice Address - Phone:916-691-5900
Practice Address - Fax:916-691-6747
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP23251363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily