Individual
CHERYL JENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5180
(505) 846-3339
Mailing address
2050A 2ND ST SE, KIRTLAND AFB, NM 87117-5522
(505) 846-3339
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN60715982
WA
163W00000X
Registered Nurse
RN9385742
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN11008823
FL
Other
Enumeration date
12/29/2016
Last updated
11/30/2020
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