Individual
CHERYL ANN COUNTRYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5122 N 382ND AVE, TONOPAH, AZ 85354-0140
(160) 237-7811
Mailing address
5122 N 382ND AVE, TONOPAH, AZ 85354-0140
(160) 237-7811
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
245602
AZ
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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