Aisha Cherry

Individual provider Active NPI Registered Nurse · Locust Grove, GA

NPI 1902331101 · NPPES record last updated Apr 25, 2017

Key facts

NPI
1902331101
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
237341 (GA)
Practice address
416 Kirkland Dr
Locust Grove, GA 30248-7220
Phone
(845) 505-4291
NPI assigned
Apr 25, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
237341GAMDRegistered Nurse
626152NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 237341 GA Yes
Registered Nurse 163W00000X 626152 NY

Addresses

Primary practice location

416 Kirkland Dr
Locust Grove, GA 30248-7220

Mailing address

416 Kirkland Dr
Locust Grove, GA 30248-7220
Phone (845) 505-4291

Other providers in Locust Grove, GA

All providers in Locust Grove, GA · Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.