Provider Demographics
NPI:1346050838
Name:PETER, CHEYENNE ALBERTA (LPN)
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:ALBERTA
Last Name:PETER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8251 W SUNSET RD UNIT 252
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2303
Mailing Address - Country:US
Mailing Address - Phone:702-460-8545
Mailing Address - Fax:
Practice Address - Street 1:8251 W SUNSET RD UNIT 252
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2303
Practice Address - Country:US
Practice Address - Phone:702-460-8545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV858422164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse