Provider Demographics
NPI:1568855146
Name:CHERYL HENRY-SMITH LLC
Entity type:Organization
Organization Name:CHERYL HENRY-SMITH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:337-258-8894
Mailing Address - Street 1:600 GENDARME RD
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-5104
Mailing Address - Country:US
Mailing Address - Phone:337-258-8894
Mailing Address - Fax:
Practice Address - Street 1:2520 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-5306
Practice Address - Country:US
Practice Address - Phone:337-234-5614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7198363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty