Provider Demographics
NPI:1215618079
Name:CHEYNEY, JENNIFER LORRIEN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LORRIEN
Last Name:CHEYNEY
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 1:12450 S ABBOTT DOWNING WAY
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5672
Mailing Address - Country:US
Mailing Address - Phone:208-365-8469
Mailing Address - Fax:
Practice Address - Street 1:228 S HOLLY ST
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-5104
Practice Address - Country:US
Practice Address - Phone:208-606-0469
Practice Address - Fax:208-739-9432
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker