Provider Demographics
NPI:1942182936
Name:MEUDT, DARISHA CHERYL ANN RONNETT
Entity type:Individual
Prefix:
First Name:DARISHA
Middle Name:CHERYL ANN RONNETT
Last Name:MEUDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3614 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-3542
Mailing Address - Country:US
Mailing Address - Phone:402-403-2415
Mailing Address - Fax:
Practice Address - Street 1:3614 GRANT ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-3542
Practice Address - Country:US
Practice Address - Phone:402-403-2415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMA0000049834173000000X
TXNA0061004884376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No173000000XOther Service ProvidersLegal Medicine