Provider Demographics
NPI:1790095073
Name:CHERRY, LATOYA NICOLE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:NICOLE
Last Name:CHERRY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LATOYA
Other - Middle Name:NICOLE
Other - Last Name:CHERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:3725 SW JACK ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-3951
Mailing Address - Country:US
Mailing Address - Phone:786-679-5825
Mailing Address - Fax:800-860-1168
Practice Address - Street 1:3174 NW FEDERAL HWY #3490
Practice Address - Street 2:SUITE 302-303
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957
Practice Address - Country:US
Practice Address - Phone:772-771-9709
Practice Address - Fax:800-860-1168
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9247990363LA2100X, 163WW0000X
FLARNP9247990363LF0000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WW0000XNursing Service ProvidersRegistered NurseWound Care