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Individual
CHERYL TAN
Active
Individual
CHERYL TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
45942
KS
363LF0000X
Family Nurse Practitioner
45942
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
45942
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178951
MEDICARE
KS
05
—
200551880A
—
KS
05
—
200551880B
—
KS
05
—
200551880D
—
KS
05
—
200551880J
—
KS
01
—
PTAN 016291004
MEDICARE - WPS
KS
Enumeration date
09/15/2006
Last updated
01/09/2024
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