Provider Demographics
NPI:1124257704
Name:PETERSON, CHERIE K (PHARMD)
Entity type:Individual
Prefix:
First Name:CHERIE
Middle Name:K
Last Name:PETERSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHERIE
Other - Middle Name:K
Other - Last Name:GOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:US ARMY HEALTH CLINIC SCHOFIELD BARRACKS
Mailing Address - Street 2:PHARMACY SERVICE BLDG 676, ROOM 104
Mailing Address - City:SCHOFIELD BARRACKS
Mailing Address - State:HI
Mailing Address - Zip Code:96857-5460
Mailing Address - Country:US
Mailing Address - Phone:808-433-8423
Mailing Address - Fax:808-433-8417
Practice Address - Street 1:SCHOFIELD BARRACKS
Practice Address - Street 2:BLDG 683, ROOM 104
Practice Address - City:SCHOFIELD BARRACKS
Practice Address - State:HI
Practice Address - Zip Code:96857-5460
Practice Address - Country:US
Practice Address - Phone:808-433-8291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-05
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH 31251835P0018X
WAPH60072007183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist