Provider Demographics
NPI:1689569444
Name:STEVENSON, CHERYL CHERRY
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:CHERRY
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:
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 834
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NC
Mailing Address - Zip Code:27845-0834
Mailing Address - Country:US
Mailing Address - Phone:252-578-9043
Mailing Address - Fax:
Practice Address - Street 1:604 ATHERTON ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NC
Practice Address - Zip Code:27845-8002
Practice Address - Country:US
Practice Address - Phone:252-578-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider