Healthcare Provider Details

I. General information

NPI: 1700597523
Provider Name (Legal Business Name): CHERYL MARIE ASHELFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 LEWIS AVE
LINCOLN NE
68521-2080
US

IV. Provider business mailing address

4600 LEWIS AVE
LINCOLN NE
68521-2080
US

V. Phone/Fax

Practice location:
  • Phone: 402-436-1213
  • Fax: 402-458-3213
Mailing address:
  • Phone: 402-436-1213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: