Provider Demographics
NPI:1629792080
Name:EILERS, MISHA ELAINE (CNA)
Entity Type:Individual
Prefix:MRS
First Name:MISHA
Middle Name:ELAINE
Last Name:EILERS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-5331
Mailing Address - Country:US
Mailing Address - Phone:308-698-8000
Mailing Address - Fax:
Practice Address - Street 1:320 W 24TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-5331
Practice Address - Country:US
Practice Address - Phone:308-698-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE144135376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide