Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LG0600X | Nurse Practitioner - Gerontology | 1085551 | KY |
Y | 363LG0600X | Nurse Practitioner - Gerontology | COA 18008 NP | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | RN 227407 | OH |
NPI | 1003285966 |
---|---|
Provider Name | Mrs. Cheryl Doreen Herrle |
First Address | Cincinnati, OH 45263-0001 |
Second Address | Cincinnati, OH 45219-4231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2015 |
Last Update Date | 17/11/2017 |