Provider Demographics
NPI:1689186264
Name:ABSOLUTE VASCULAR, LLC
Entity Type:Organization
Organization Name:ABSOLUTE VASCULAR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:620-757-5701
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:KS
Mailing Address - Zip Code:66861-0045
Mailing Address - Country:US
Mailing Address - Phone:620-382-4830
Mailing Address - Fax:
Practice Address - Street 1:2096 SUNRISE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:KS
Practice Address - Zip Code:66861-9597
Practice Address - Country:US
Practice Address - Phone:620-382-4830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-03
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1395010163W00000X
KS1389589062163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty