Healthcare Provider Details

I. General information

NPI: 1457234932
Provider Name (Legal Business Name): MARISA ROSALINDA GADWAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS MARISA ROSALINDA GADWAY

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 10TH AVE
SIDNEY NE
69162-1609
US

IV. Provider business mailing address

2450 PARKVIEW DR
SIDNEY NE
69162-2358
US

V. Phone/Fax

Practice location:
  • Phone: 308-249-6728
  • Fax: 308-365-6868
Mailing address:
  • Phone: 308-249-6728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: