Provider Demographics
NPI:1487951471
Name:WINEY, CHERYL (NP)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:WINEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1388 EASTTOWN DR
Mailing Address - Street 2:
Mailing Address - City:IOWA
Mailing Address - State:LA
Mailing Address - Zip Code:70647-3816
Mailing Address - Country:US
Mailing Address - Phone:337-309-1967
Mailing Address - Fax:337-491-0923
Practice Address - Street 1:1615 JOHNSON ST
Practice Address - Street 2:SUITE B
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-3650
Practice Address - Country:US
Practice Address - Phone:337-785-4756
Practice Address - Fax:337-824-5181
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LATAP002518363LA2200X
TX727112363LA2200X
LAAP06447363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health