Provider Demographics
NPI:1124145461
Name:CARROLL, CHERYL CHEEK (CNM, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:CHEEK
Last Name:CARROLL
Suffix:
Gender:F
Credentials:CNM, PMHNP-BC
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 51224
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27717-1224
Mailing Address - Country:US
Mailing Address - Phone:919-493-6523
Mailing Address - Fax:919-479-0881
Practice Address - Street 1:209 E CARVER ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2133
Practice Address - Country:US
Practice Address - Phone:919-471-2273
Practice Address - Fax:919-479-0881
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5002178363LP0808X
NC108367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health