| NPI | 1710262308 |
|---|---|
| Former Name | CHERYL LYNN HEATHERLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71003761) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28088897) |
| Enumeration Date | 2011-10-15 |
| Last Update Date | 2013-02-06 |