Provider Demographics
NPI:1477858249
Name:VISITING NURSE ASSOCIATION OF WISCONSIN, INC
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF WISCONSIN, INC
Other - Org Name:AURORA VISITING NURSE ASSOCIATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HENNESSY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RN
Authorized Official - Phone:414-328-4490
Mailing Address - Street 1:11333 W NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-3111
Mailing Address - Country:US
Mailing Address - Phone:414-327-2295
Mailing Address - Fax:
Practice Address - Street 1:10600 N PORT WASHINGTON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5093
Practice Address - Country:US
Practice Address - Phone:262-240-3116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AURORA HEALTH CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies