Provider Demographics
NPI:1891536819
Name:SENITA, CHOLLIA (CNA)
Entity type:Individual
Prefix:
First Name:CHOLLIA
Middle Name:
Last Name:SENITA
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 1:304 HANCOCK ST # I-J
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6573
Mailing Address - Country:US
Mailing Address - Phone:207-852-8109
Mailing Address - Fax:
Practice Address - Street 1:304 HANCOCK ST # I-J
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6573
Practice Address - Country:US
Practice Address - Phone:720-290-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME105257376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide