Provider Demographics
NPI:1083914790
Name:CHENEY, AMBER BROWN (RPH)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:BROWN
Last Name:CHENEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3627 AIRPORT WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4779
Mailing Address - Country:US
Mailing Address - Phone:907-374-4060
Mailing Address - Fax:907-374-4019
Practice Address - Street 1:3627 AIRPORT WAY
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4779
Practice Address - Country:US
Practice Address - Phone:907-374-4060
Practice Address - Fax:907-374-4019
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1026183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist