Provider Demographics
NPI:1760672216
Name:NURSE PROVIDERS, INC.
Entity Type:Organization
Organization Name:NURSE PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:VILMONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-399-1700
Mailing Address - Street 1:344 N. 76TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114
Mailing Address - Country:US
Mailing Address - Phone:402-399-1700
Mailing Address - Fax:402-393-0883
Practice Address - Street 1:344 N 76TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3681
Practice Address - Country:US
Practice Address - Phone:402-399-1700
Practice Address - Fax:402-393-0883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE287072251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE287072Medicare PIN