Provider Demographics
NPI:1912474362
Name:CHERRY, LINDA M
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:CHERRY
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 1:5750 CHESAPEAKE BLVD STE 313
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23513-5325
Mailing Address - Country:US
Mailing Address - Phone:757-875-0520
Mailing Address - Fax:
Practice Address - Street 1:5750 CHESAPEAKE BLVD STE 313
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-5325
Practice Address - Country:US
Practice Address - Phone:757-875-0520
Practice Address - Fax:757-858-9727
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-191941372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion