| NPI | 1689693954 |
|---|---|
| Former Name | CHERYL WYNETTE GUSTAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R597686) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS R597686) |
| 163WC0400X Registered Nurse, Case Management (Licence: MS R597686) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2013-04-01 |