Provider Demographics
NPI:1801958103
Name:MCNALLEY, CHERYL E (WHCNP)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:E
Last Name:MCNALLEY
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:MRS
Other - First Name:CHERYL
Other - Middle Name:E
Other - Last Name:MCNALLEY CANNATA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:WHNP-BC
Mailing Address - Street 1:PO BOX 412
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-0412
Mailing Address - Country:US
Mailing Address - Phone:713-208-0494
Mailing Address - Fax:
Practice Address - Street 1:1019 EVERGREEN ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-7675
Practice Address - Country:US
Practice Address - Phone:713-208-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229859363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX107897403Medicaid
TXS56662Medicare UPIN
TX107897403Medicaid