Provider Demographics
NPI:1679770283
Name:BAKEWELL, CHERYLE ELAINE (CNP, APRN-BC, FNP)
Entity type:Individual
Prefix:MS
First Name:CHERYLE
Middle Name:ELAINE
Last Name:BAKEWELL
Suffix:
Gender:F
Credentials:CNP, APRN-BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 ALDABA CIR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-0839
Mailing Address - Country:US
Mailing Address - Phone:505-259-4702
Mailing Address - Fax:
Practice Address - Street 1:4808 MCMAHON BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5010
Practice Address - Country:US
Practice Address - Phone:505-272-9676
Practice Address - Fax:505-277-1363
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN438237363LF0000X
NMRN-70132, CNP01545363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily