Provider Demographics
NPI:1841892692
Name:TRAVERS, CHERYL LYNN
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:TRAVERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9734 DENROB CT
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-1861
Mailing Address - Country:US
Mailing Address - Phone:443-613-1664
Mailing Address - Fax:
Practice Address - Street 1:9734 DENROB CT
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-1861
Practice Address - Country:US
Practice Address - Phone:443-613-1664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist