Provider Demographics
NPI:1265455190
Name:THE VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY, IOWA
Entity Type:Organization
Organization Name:THE VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY, IOWA
Other - Org Name:VNA OF POTTAWATTAMIE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JEPPESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-328-2636
Mailing Address - Street 1:300 W BROADWAY
Mailing Address - Street 2:SUITE 10
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-9045
Mailing Address - Country:US
Mailing Address - Phone:712-328-2636
Mailing Address - Fax:712-328-0839
Practice Address - Street 1:300 W BROADWAY
Practice Address - Street 2:SUITE 10
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-9045
Practice Address - Country:US
Practice Address - Phone:712-328-2636
Practice Address - Fax:712-328-0839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0051433OtherMEDICAID ENHANCED
IA6000006OtherUNITED HEALTH CARE
IA67001OtherBLUE CROSS BLUE SHIELD
IA0670018Medicaid
IA0088831OtherMEDICAID EPSDT
IA87146OtherCOVENTRY
IAF680OtherMIDLANDS CHOICE
IAF680OtherMIDLANDS CHOICE
IA0670018Medicaid