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General NPI Number Information
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NPI Number | 1447173497
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Entity Type | Individual
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Provider Name | MR. CAMERON JAMES SIS
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Gender | Male
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 34430 ROAD 757
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City | ELSIE
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State | NE
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Zip | 69134-4046
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Country | US
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Telephone | 308-289-1113
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Fax |
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Provider Business Mailing Address
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Address Line | 310 PERKINS AVE
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City | ELSIE
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State | NE
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Zip | 69134-2030
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Country | US
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Telephone | 308-289-6419
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 75005945
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License Number State | NE
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