Provider Demographics
NPI:1063301604
Name:PRICE, CHEYANNE LARENE
Entity type:Individual
Prefix:
First Name:CHEYANNE
Middle Name:LARENE
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 N 204TH AVENUE CIR
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-1830
Mailing Address - Country:US
Mailing Address - Phone:402-819-4059
Mailing Address - Fax:
Practice Address - Street 1:613 N 204TH AVENUE CIR
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-1830
Practice Address - Country:US
Practice Address - Phone:402-819-4059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician