Provider Demographics
NPI:1063434561
Name:KEAHEY, CHERIE L (CRNP)
Entity type:Individual
Prefix:
First Name:CHERIE
Middle Name:L
Last Name:KEAHEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35902-0097
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1989 SARDIS DR
Practice Address - Street 2:
Practice Address - City:SARDIS CITY
Practice Address - State:AL
Practice Address - Zip Code:35956-2344
Practice Address - Country:US
Practice Address - Phone:256-492-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1046883363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL630400099Medicaid
AL630401099Medicaid
AL630403099Medicaid
AL630413099Medicaid
AL630405099Medicaid
AL104626Medicaid
AL630406099Medicaid
AL630402099Medicaid
AL630408099Medicaid
AL630402099Medicaid
AL630400099Medicaid