Provider Demographics
NPI:1366759888
Name:BOURNE, CHERYL L (CNP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:BOURNE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:L
Other - Last Name:HILLIARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-685-4614
Mailing Address - Fax:614-685-5025
Practice Address - Street 1:6700 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-3508
Practice Address - Country:US
Practice Address - Phone:614-685-4614
Practice Address - Fax:614-685-5025
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11766-NP363LF0000X
OHAPRN.CNP.11766363L00000X
OH319335163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse