Provider Demographics
NPI:1043865165
Name:TRANSFORMATIVE HEALTHCARE
Entity Type:Organization
Organization Name:TRANSFORMATIVE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:402-307-5510
Mailing Address - Street 1:11810 NICHOLAS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4449
Mailing Address - Country:US
Mailing Address - Phone:402-307-5510
Mailing Address - Fax:402-204-1081
Practice Address - Street 1:11810 NICHOLAS ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4449
Practice Address - Country:US
Practice Address - Phone:402-307-5510
Practice Address - Fax:402-204-1081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty