Individual
MS. CHEERISH S ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NA
Contact information
Practice address
4721 TROUT LN, BLAIR, NE 68008-6286
(402) 658-8200
Mailing address
4721 TROUT LN, BLAIR, NE 68008-6286
(402) 658-8200
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
125151
NE
3747P1801X
Personal Care Attendant
Primary
125151
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125151
STATE
NE
Enumeration date
11/08/2016
Last updated
11/08/2016
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