Provider Demographics
NPI:1144558685
Name:HAYNES, CHERYL E (RPH)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:E
Last Name:HAYNES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1222
Mailing Address - Street 2:
Mailing Address - City:WRANGELL
Mailing Address - State:AK
Mailing Address - Zip Code:99929-1222
Mailing Address - Country:US
Mailing Address - Phone:907-347-2394
Mailing Address - Fax:
Practice Address - Street 1:322 BENNETT ST
Practice Address - Street 2:ISLAND, ONLY ADDRESSES PONUMBERS-POB 1421
Practice Address - City:WRANGELL
Practice Address - State:AK
Practice Address - Zip Code:99929
Practice Address - Country:US
Practice Address - Phone:907-874-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1816183500000X
AL13335183500000X
FL26472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1816OtherSTATE OF ALASKA BOARD OF PHARMACY