Provider Demographics
NPI:1689998015
Name:MCKEVITT, CHERIE DISALVO (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CHERIE
Middle Name:DISALVO
Last Name:MCKEVITT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:CHERIE
Other - Middle Name:THERESA
Other - Last Name:DISALVO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:2019 GREEN CT
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-8470
Mailing Address - Country:US
Mailing Address - Phone:985-727-7258
Mailing Address - Fax:985-727-4721
Practice Address - Street 1:3555 HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3138
Practice Address - Country:US
Practice Address - Phone:985-626-5693
Practice Address - Fax:985-727-4721
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-14
Last Update Date:2010-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist