Provider Demographics
NPI:1811389042
Name:CHENEY, DANA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:CHENEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S MILL ST
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:KS
Mailing Address - Zip Code:67420-3237
Mailing Address - Country:US
Mailing Address - Phone:785-738-2285
Mailing Address - Fax:785-738-5144
Practice Address - Street 1:110 S MILL ST
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:KS
Practice Address - Zip Code:67420-3237
Practice Address - Country:US
Practice Address - Phone:785-738-2285
Practice Address - Fax:785-738-5144
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist