Individual
MADISON JAZLYNN TAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
62296 736 RD # NE68329, COOK, NE 68329-9612
(402) 269-6754
Mailing address
62296 736 RD # NE68329, COOK, NE 68329-9612
(402) 269-6754
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
140744
NE
Other
Enumeration date
02/21/2025
Last updated
02/21/2025
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