Individual
CHERYL P ATHEARN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4320 SEMINARY RD, ALEXANDRIA HOSPITAL, ALEXANDRIA, VA 22304
(703) 504-3066
(703) 504-3866
Mailing address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-1804
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10775
MN
363A00000X
Physician Assistant
Primary
PA9107831
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00339583
RAILROAD MEDICARE
MD
Enumeration date
03/23/2006
Last updated
01/11/2023
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