Provider Demographics
NPI:1346067485
Name:RODE, CHEYENNE (LPN)
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:
Last Name:RODE
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 10TH ST SE
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-4018
Mailing Address - Country:US
Mailing Address - Phone:015-442-0047
Mailing Address - Fax:
Practice Address - Street 1:806 10TH ST SE
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-4018
Practice Address - Country:US
Practice Address - Phone:701-544-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDL17541164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse