Provider Demographics
NPI:1588863500
Name:OETJEN, CHERYL ANN (FNP)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANN
Last Name:OETJEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9430 FORESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4753
Mailing Address - Country:US
Mailing Address - Phone:703-283-6565
Mailing Address - Fax:703-365-0332
Practice Address - Street 1:9430 FORESTWOOD LN
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4753
Practice Address - Country:US
Practice Address - Phone:703-283-6565
Practice Address - Fax:703-365-0332
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily