Provider Demographics
NPI:1548539901
Name:BARRETT, CHERYLL ANNE (LPN)
Entity type:Individual
Prefix:
First Name:CHERYLL
Middle Name:ANNE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 TURK HILL RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-3504
Mailing Address - Country:US
Mailing Address - Phone:845-279-3702
Mailing Address - Fax:
Practice Address - Street 1:570 ROUTE 312
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-3711
Practice Address - Country:US
Practice Address - Phone:845-279-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105876-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse