Provider Demographics
NPI:1437859766
Name:PLAISTED, CHEYENNE N (CPHT)
Entity Type:Individual
Prefix:MISS
First Name:CHEYENNE
Middle Name:N
Last Name:PLAISTED
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25945 HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-6571
Mailing Address - Country:US
Mailing Address - Phone:302-612-0006
Mailing Address - Fax:
Practice Address - Street 1:24892 JOHN J WILLIAMS HWY
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-4939
Practice Address - Country:US
Practice Address - Phone:302-947-1204
Practice Address - Fax:302-947-9402
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE30225174183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician