Individual
CHERYL DAVIS-LAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
6745 GRAY RD STE D, INDIANAPOLIS, IN 46237-3236
(317) 859-1090
(317) 941-7254
Mailing address
PO BOX 100, BEECH GROVE, IN 46107-0100
(317) 859-1090
(317) 941-7254
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71000734A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71000734A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007695
M PLAN
IN
01
—
000000545412
ANTHEM
IN
01
—
110200160
RAILROAD MEDICARE
IN
01
—
11478689
CAQH
IN
05
—
200184580
—
IN
01
—
28082714A
RN LICENSE
IN
01
—
35-1994904
TID
IN
01
—
71000734B
CSR
IN
Enumeration date
01/23/2007
Last updated
03/07/2023
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