Provider Demographics
NPI:1487755674
Name:THE DUBUQUE VISITING NURSE ASSOCIATION
Entity type:Organization
Organization Name:THE DUBUQUE VISITING NURSE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOLBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-589-2414
Mailing Address - Street 1:PO BOX 35515
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50315-0305
Mailing Address - Country:US
Mailing Address - Phone:515-557-3236
Mailing Address - Fax:
Practice Address - Street 1:660 IOWA ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-4836
Practice Address - Country:US
Practice Address - Phone:563-556-6200
Practice Address - Fax:563-556-4371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0670588Medicaid
167058Medicare ID - Type Unspecified