Individual
CHERIE CYNTHIA FORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
14724 ESCALONA RD, LA MIRADA, CA 90638-4548
(562) 225-5130
Mailing address
14724 ESCALONA RD, LA MIRADA, CA 90638-4548
(562) 225-5130
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
908903
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017029785
FAMILY NURSE PRACTITIONER
CA
01
—
498903
REGISTERED NURSE
CA
Enumeration date
07/09/2018
Last updated
07/09/2018
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