Basic Information
| Provider Information | |||||||||
| NPI: | 1679770283 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAKEWELL | ||||||||
| FirstName: | CHERYLE | ||||||||
| MiddleName: | ELAINE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CNP, APRN-BC, FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 304 ALDABA CIR NE | ||||||||
| Address2: | |||||||||
| City: | RIO RANCHO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871240839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052594702 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4808 MCMAHON BLVD NW | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871145010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052729676 | ||||||||
| FaxNumber: | 5052771363 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2007 | ||||||||
| LastUpdateDate: | 03/19/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN438237 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | RN-70132, CNP01545 | NM | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.