Provider Demographics
NPI:1780996462
Name:CHERRY, ERNESTINE N (R/N)
Entity type:Individual
Prefix:MRS
First Name:ERNESTINE
Middle Name:N
Last Name:CHERRY
Suffix:
Gender:F
Credentials:R/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 RIVER BEND DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4914
Mailing Address - Country:US
Mailing Address - Phone:214-743-6159
Mailing Address - Fax:214-689-6482
Practice Address - Street 1:1818 CORSICANA ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-6102
Practice Address - Country:US
Practice Address - Phone:214-939-3933
Practice Address - Fax:214-653-1962
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX226417163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse