Doctor Name: | MRS. CHERITY GURGANUS |
NPI Number: | 1750656120 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PMHNP |
License Number: | 175911 |
Business Practice Address: | 343 Swinson Dr Dudley, NC - 283335362 |
Business Phone Number: | 2522581815 |
Business Fax Number: | |
Mailing Address: | 343 Swinson Dr, DUDLEY |
State: | NC |
Postal Code: | 283335362 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/17/2012 |
NPI Last Update Date: | 03/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 175911 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |