Organization
C & K NURSE PRACTITIONER SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL GILBREATH APN (PRESIDENT)
(254) 749-4298
Entity
Organization
Contact information
Practice address
415 EASY ST, MARLIN, TX 76661
(512) 300-2455
Mailing address
415 EASY ST, MARLIN, TX 76661
(512) 300-2455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00954U
BCBS TX GROUP #
TX
05
—
158458301
—
TX
Enumeration date
06/11/2006
Last updated
06/12/2008
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