Provider Demographics
NPI:1821532888
Name:NAQUIN, CHEYENNE (ATC)
Entity Type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:
Last Name:NAQUIN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 N MAIN PROJECT RD
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-7409
Mailing Address - Country:US
Mailing Address - Phone:985-360-8579
Mailing Address - Fax:
Practice Address - Street 1:906 E 1ST ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6701
Practice Address - Country:US
Practice Address - Phone:985-448-4837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-11
Last Update Date:2017-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer