Provider Demographics
NPI:1063564615
Name:ROHLIK, CHERYL LYNN (MSN)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:LYNN
Last Name:ROHLIK
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:LYNN
Other - Last Name:TIBLETS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:5017 HERITAGE AVENUE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034
Mailing Address - Country:US
Mailing Address - Phone:817-545-9100
Mailing Address - Fax:817-545-9134
Practice Address - Street 1:5017 HERITAGE AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034
Practice Address - Country:US
Practice Address - Phone:817-545-9100
Practice Address - Fax:817-545-9134
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX634699363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health