Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Cheryl Nicole Thacker, AGPCNP-BC

Individual provider Nurse Practitioner · NPI 1336972264

Cheryl Nicole Thacker, AGPCNP-BC is a Nurse Practitioner in Jacksonville, Florida. Qualified in 2024, 2 years ago. Practices with Cardiorenal Therapeutics LLC, a 34-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
2
Licensed in
FL
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

4866 Big Island Dr Unit 5
Jacksonville, FL 32246-5301
Phone: (904) 652-0652
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 11034425 (FL)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence 11034425 (FL)

Record details

NPI number1336972264
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGPCNP-BC
Sole proprietorNo
NPI enumeratedAugust 26, 2024
Last updated in NPPESAugust 26, 2024
Certification dateAugust 25, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Cardiorenal Therapeutics Llc — 34 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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