Provider Demographics
NPI:1306615133
Name:NESBITT, CHERYL (CNM,)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:NESBITT
Suffix:
Gender:F
Credentials:CNM,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5024 HIDDEN CREEK LN
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-4111
Mailing Address - Country:US
Mailing Address - Phone:714-488-8131
Mailing Address - Fax:
Practice Address - Street 1:2825 CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6039
Practice Address - Country:US
Practice Address - Phone:916-887-0681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236424367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife