Provider Demographics
NPI:1093264392
Name:NASH HOME HEALTHCARE
Entity Type:Organization
Organization Name:NASH HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:NORA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANESAKDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-364-8923
Mailing Address - Street 1:10721 W CAPITOL DR # 200
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1210
Mailing Address - Country:US
Mailing Address - Phone:414-305-9407
Mailing Address - Fax:844-466-8405
Practice Address - Street 1:10721 W CAPITOL DR # 200
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1210
Practice Address - Country:US
Practice Address - Phone:414-305-9407
Practice Address - Fax:844-466-8405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization