Provider Demographics
NPI:1174310577
Name:CHEATHAM, ELIZABETH JOYE (MSN, FNP- C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JOYE
Last Name:CHEATHAM
Suffix:
Gender:M
Credentials:MSN, FNP- C
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5750 JOHNSTON ST STE 205
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-5345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1512 WHEELER AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-5024
Practice Address - Country:US
Practice Address - Phone:505-688-1472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV857002363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty