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Cheyene Nickerson
NPI 1306369681 · on the registry since 2017 · sole proprietor
Practice
- Address
- 565 Jensen Grove Dr
Blackfoot, ID 83221 - Phone
- (208) 785-0277
- Organisation at this address
- Walmart Inc.
Wal-Mart Stores, IncInferred from a shared address, not stated in the registry. - Clinicians at this address
- 5
Registry record
- Primary taxonomy
- Pharmacist
183500000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-01-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho