Provider Demographics
NPI:1457042806
Name:ONEIDA NATION
Entity Type:Organization
Organization Name:ONEIDA NATION
Other - Org Name:ONEIDA NATION-LONG TERM CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING, CONTRACT, CRED SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-869-4910
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:WI
Mailing Address - Zip Code:54155-0365
Mailing Address - Country:US
Mailing Address - Phone:920-869-2711
Mailing Address - Fax:920-869-6329
Practice Address - Street 1:525 AIRPORT DR
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:WI
Practice Address - Zip Code:54155-9035
Practice Address - Country:US
Practice Address - Phone:920-869-2711
Practice Address - Fax:920-869-6329
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONEIDA NATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term CareGroup - Multi-Specialty