Provider Demographics
NPI:1316272263
Name:WINTER, CHERRIE HERARD (CFNP)
Entity type:Individual
Prefix:MRS
First Name:CHERRIE
Middle Name:HERARD
Last Name:WINTER
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EUPORA
Mailing Address - State:MS
Mailing Address - Zip Code:39744-2023
Mailing Address - Country:US
Mailing Address - Phone:662-258-7533
Mailing Address - Fax:
Practice Address - Street 1:1700 VETERANS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:EUPORA
Practice Address - State:MS
Practice Address - Zip Code:39744-2023
Practice Address - Country:US
Practice Address - Phone:662-258-7533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR865971363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03822221Medicaid