Provider Demographics
NPI:1124142237
Name:BARTLETT, CHERYL (CRNA)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3990 E US HIGHWAY 64 ALT
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-6843
Mailing Address - Country:US
Mailing Address - Phone:828-837-8161
Mailing Address - Fax:828-835-7723
Practice Address - Street 1:3990 E US HIGHWAY 64 ALT
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6843
Practice Address - Country:US
Practice Address - Phone:828-837-8161
Practice Address - Fax:828-835-7723
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC074398367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8051620Medicaid
NC2616432AMedicare ID - Type Unspecified