Provider Demographics
NPI:1083127013
Name:CHERESON, MICHELE ANN (CRNP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:CHERESON
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 1:904 WILKINS RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-1270
Mailing Address - Country:US
Mailing Address - Phone:814-490-9766
Mailing Address - Fax:260-234-3428
Practice Address - Street 1:1012 W BAYFRONT PKWY
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-2324
Practice Address - Country:US
Practice Address - Phone:814-455-1630
Practice Address - Fax:260-234-3428
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018093207Q00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine