| Doctor Name: | MS. CHERYL SMITH O'DONOGHUE |
| NPI Number: | 1194081521 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, FNP-BC |
| License Number: | RN062128 |
| Business Practice Address: | 2060 Dan Proctor Dr Suite 2100 St Marys, GA - 315587102 |
| Business Phone Number: | 9128826767 |
| Business Fax Number: | 9128826411 |
| Mailing Address: | 2060 Dan Proctor Dr, Suite 2100 ST MARYS |
| State: | GA |
| Postal Code: | 315587102 |
| Phone Number: | 9128826767 |
| Fax Number: | 9128826411 |
| NPI Enumeration Date: | 04/10/2012 |
| NPI Last Update Date: | 11/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN062128 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |