Provider Demographics
NPI:1962975300
Name:ANCHETA, CHERRY ANN
Entity type:Individual
Prefix:
First Name:CHERRY ANN
Middle Name:
Last Name:ANCHETA
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 1:91-1052 ANAUNAU ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-3936
Mailing Address - Country:US
Mailing Address - Phone:808-371-1444
Mailing Address - Fax:
Practice Address - Street 1:91-1052 ANAUNAU ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3936
Practice Address - Country:US
Practice Address - Phone:808-371-1444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1-180077251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health