Provider Demographics
NPI:1518959923
Name:FOGLE, CHERI LYNN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:LYNN
Last Name:FOGLE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 HOPKINSVILLE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42345-1231
Mailing Address - Country:US
Mailing Address - Phone:270-377-3077
Mailing Address - Fax:270-337-3002
Practice Address - Street 1:228 HOPKINSVILLE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:KY
Practice Address - Zip Code:42345-1231
Practice Address - Country:US
Practice Address - Phone:270-377-3077
Practice Address - Fax:270-338-3077
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003708363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78007218Medicaid
KY78007218Medicaid
KY0652416Medicare PIN