Provider Demographics
NPI:1558361006
Name:VISITING NURSE ASSOCIATION OF JOHNSON COUNTY
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF JOHNSON COUNTY
Other - Org Name:JOHNSON COUNTY VISITING NURSE ASSOCIATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVOTNY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BS/BA, MHA
Authorized Official - Phone:319-337-9686
Mailing Address - Street 1:1524 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6021
Mailing Address - Country:US
Mailing Address - Phone:319-337-9686
Mailing Address - Fax:319-337-5566
Practice Address - Street 1:1524 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6021
Practice Address - Country:US
Practice Address - Phone:319-337-9686
Practice Address - Fax:319-337-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-27
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA67014OtherBLUE CROSS
IA0670141Medicaid
IA67014OtherBLUE CROSS