Individual
CHERIA RUSSENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
801 W LOCUST ST, CABOT, AR 72023-2414
(501) 424-3016
Mailing address
801 W LOCUST ST, CABOT, AR 72023-2414
(501) 424-3016
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
P0007500
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196555758
—
AR
Enumeration date
07/26/2006
Last updated
10/25/2019
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