Provider Demographics
NPI:1841522315
Name:HERNDON, CHERYL DARLENE (ARNP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:DARLENE
Last Name:HERNDON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:DARLENE
Other - Last Name:HERNDON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:1000 37TH PL STE 105
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6579
Mailing Address - Country:US
Mailing Address - Phone:772-562-2402
Mailing Address - Fax:772-562-5842
Practice Address - Street 1:1000 37TH PL STE 105
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6579
Practice Address - Country:US
Practice Address - Phone:772-562-2402
Practice Address - Fax:772-562-5842
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2571572174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 2571572OtherLICENSE NUMBER