Provider Demographics
NPI:1306188115
Name:ERNESTI, MARIE (DC)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:ERNESTI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:BURWELL
Mailing Address - State:NE
Mailing Address - Zip Code:68823-0515
Mailing Address - Country:US
Mailing Address - Phone:308-346-5191
Mailing Address - Fax:
Practice Address - Street 1:177 S 8TH AVE
Practice Address - Street 2:
Practice Address - City:BURWELL
Practice Address - State:NE
Practice Address - Zip Code:68823-0515
Practice Address - Country:US
Practice Address - Phone:308-346-5191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-19
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1747111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor