Provider Demographics
NPI:1326835802
Name:TANOUS-TOMONELLI, ELIZABETH MARIE (CMA,PSS,)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE
Last Name:TANOUS-TOMONELLI
Suffix:
Gender:
Credentials:CMA,PSS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-4415
Mailing Address - Country:US
Mailing Address - Phone:712-828-0978
Mailing Address - Fax:
Practice Address - Street 1:7101 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-2164
Practice Address - Country:US
Practice Address - Phone:402-572-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NECPSS-195175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist