Provider Demographics
NPI:1619673126
Name:VARGAS, NEMY ENDOSO (RN)
Entity Type:Individual
Prefix:MRS
First Name:NEMY
Middle Name:ENDOSO
Last Name:VARGAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14474 WALKING STICK WAY
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-7843
Mailing Address - Country:US
Mailing Address - Phone:216-312-9486
Mailing Address - Fax:
Practice Address - Street 1:14474 WALKING STICK WAY
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-7843
Practice Address - Country:US
Practice Address - Phone:216-312-9486
Practice Address - Fax:440-572-1581
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHR136324163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRM686317OtherOHIO DRIVER,S LICENCE