Provider Demographics
NPI:1275335879
Name:PUNTIL, CHERYL A (MN, APRN, PMHCNS,BC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:PUNTIL
Suffix:
Gender:
Credentials:MN, APRN, PMHCNS,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 1374
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01262-1374
Mailing Address - Country:US
Mailing Address - Phone:310-721-1558
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1374
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01262-1374
Practice Address - Country:US
Practice Address - Phone:310-721-1558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2328088163WP0808X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health