Healthcare Provider Details

I. General information

NPI: 1548192016
Provider Name (Legal Business Name): ERICA L CUELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 6TH AVE
SIDNEY NE
69162-1724
US

IV. Provider business mailing address

1116 10TH AVE STE A
SIDNEY NE
69162-2001
US

V. Phone/Fax

Practice location:
  • Phone: 308-524-5573
  • Fax:
Mailing address:
  • Phone: 308-524-5573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: