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NPI Code Detail

MEDICARE: CHANELL BOONE

MEDICARE: CHANELL BOONE
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1372500000XChore ProviderNE
2376J00000XHomemakerNE

General Provider Information

NPI Number : 1609689710
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANELL BOONE
Provider Business Mailing Address
First Line : 3160 AMES AVE
Second Line :
City : OMAHA
State : NE
Zip : 68111-2759
Country : US
Telephone Number : 303-520-3042
Fax Number :
Provider Business Practice Location Address
First Line : 3160 AMES AVE
Second Line :
City : OMAHA
State : NE
Zip : 68111-2759
Country : US
Telephone Number : 303-520-3042
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2025
Last Update Date : 03/28/2025

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Directions to “ CHANELL BOONE ” Practice Location

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