Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | UP006929B | PA |
NPI | 1003882390 |
---|---|
Provider Name | Cheryl Carey |
First Address | Dunmore, PA 18512-0349 |
Second Address | Wilkes Barre, PA 18764-0999 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 31/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P43516 | (02) | PA |