Provider Demographics
NPI:1982404414
Name:CHHIM, CHEYENNE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:
Last Name:CHHIM
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:CHEYENNE
Other - Middle Name:
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6413 BROMFIELD TRCE
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-3902
Mailing Address - Country:US
Mailing Address - Phone:571-424-0050
Mailing Address - Fax:
Practice Address - Street 1:10721 MAIN ST STE 2400
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6902
Practice Address - Country:US
Practice Address - Phone:703-270-0225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024192638363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health