Provider Demographics
NPI:1144363953
Name:KREWSKY, CHERYL L (NP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:KREWSKY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:LENA ROBINSON
Other - Last Name:KREWSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1001 GAUSE BLVD # 75
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2939
Mailing Address - Country:US
Mailing Address - Phone:985-280-3609
Mailing Address - Fax:985-280-9651
Practice Address - Street 1:1051 GAUSE BLVD STE 370
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2998
Practice Address - Country:US
Practice Address - Phone:985-280-6220
Practice Address - Fax:985-280-9228
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05069363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2142411Medicaid
LA325835YWX1Medicare PIN
LA2142411Medicaid