Provider Demographics
NPI:1952436347
Name:DANIELS, CHERI MARIE (PA, ATC)
Entity Type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:MARIE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:PA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 W WACKERLY ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2739
Mailing Address - Country:US
Mailing Address - Phone:989-631-9515
Mailing Address - Fax:
Practice Address - Street 1:419 W WACKERLY ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2739
Practice Address - Country:US
Practice Address - Phone:989-631-9515
Practice Address - Fax:989-835-6824
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant