Healthcare Provider Details

I. General information

NPI: 1942182936
Provider Name (Legal Business Name): DARISHA CHERYL ANN RONNETT MEUDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3614 GRANT ST
OMAHA NE
68111-3542
US

IV. Provider business mailing address

3614 GRANT ST
OMAHA NE
68111-3542
US

V. Phone/Fax

Practice location:
  • Phone: 402-403-2415
  • Fax:
Mailing address:
  • Phone: 402-403-2415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMA0000049834
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNA0061004884
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: