Provider Demographics
NPI:1114548757
Name:MY NURSE HEALTHCARE, LLC
Entity Type:Organization
Organization Name:MY NURSE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WYSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:402-250-8465
Mailing Address - Street 1:124 HURON CIR
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-8327
Mailing Address - Country:US
Mailing Address - Phone:402-250-8465
Mailing Address - Fax:267-790-5172
Practice Address - Street 1:124 HURON CIR
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-8327
Practice Address - Country:US
Practice Address - Phone:402-250-8465
Practice Address - Fax:267-790-5172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care