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General NPI Number Information
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NPI Number | 1689269342
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Entity Type | Individual
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Provider Name | SHERITA NICOLE EDWARDS CNA
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Gender | Female
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 06/16/2021
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Provider Practice Location Address
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Address Line | 14736 DOBSON AVE
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City | DOLTON
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State | IL
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Zip | 60419-2313
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Country | US
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Telephone | 708-224-6471
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Fax | 708-487-9293
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Provider Business Mailing Address
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Address Line | 14736 DOBSON AVE
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City | DOLTON
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State | IL
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Zip | 60419-2313
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Country | US
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Telephone | 708-224-6471
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Fax | 708-487-9293
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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