# CHERYL TAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1588760003
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 45942 | KS | — |
| 363LF0000X | Family Nurse Practitioner | 45942 | KS | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 45942 | KS | Yes |

## Other

- **Enumeration date:** 09/15/2006
- **Last updated:** 01/09/2024

## 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 |