Provider Demographics
NPI:1063017333
Name:MCKEEHAN, CHEYENNE JADE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:JADE
Last Name:MCKEEHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHEYENNE
Other - Middle Name:JADE
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50313-4403
Mailing Address - Country:US
Mailing Address - Phone:515-282-8454
Mailing Address - Fax:515-282-8450
Practice Address - Street 1:215 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50313-4403
Practice Address - Country:US
Practice Address - Phone:515-282-8454
Practice Address - Fax:515-282-8450
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist