MEDICARE: CHERYL LORRAINE KINCAID

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	372600000X	Adult Companion
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1568269496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL LORRAINE KINCAID

Provider Business Mailing Address
First Line	:	3033 W CAPITAL AVE APT 21
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68803-1817
Country	:	US
Telephone Number	:	308-267-8050
Fax Number	:

Provider Business Practice Location Address
First Line	:	3033 W CAPITAL AVE APT 21
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68803-1817
Country	:	US
Telephone Number	:	308-267-8050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2025
Last Update Date	:	02/27/2025

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