Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN9217938 | FL |
NPI | 1003300781 |
---|---|
Provider Name | Cheryl Millheim |
First Address | Lutz, FL 33549-2919 |
Second Address | Lutz, FL 33549-2919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2018 |
Last Update Date | 18/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003300781 | (05) | FL |