Provider Demographics
NPI:1154923746
Name:HARRIS, CHERYL LYNN (FNP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 ARCHEY BR
Mailing Address - Street 2:
Mailing Address - City:GREENUP
Mailing Address - State:KY
Mailing Address - Zip Code:41144-8911
Mailing Address - Country:US
Mailing Address - Phone:606-473-5565
Mailing Address - Fax:
Practice Address - Street 1:840 ARCHEY BR
Practice Address - Street 2:
Practice Address - City:GREENUP
Practice Address - State:KY
Practice Address - Zip Code:41144-8911
Practice Address - Country:US
Practice Address - Phone:606-473-5565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV105685363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily