1750308698 NPI number — NURSE IN THE HOUSE INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750308698 NPI number — NURSE IN THE HOUSE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NURSE IN THE HOUSE INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750308698
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 W BURLINGTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRFIELD
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52556-3242
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-472-4464
Provider Business Mailing Address Fax Number:
641-472-2551

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 W BURLINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRFIELD
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52556-3242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-472-4464
Provider Business Practice Location Address Fax Number:
641-472-2551
Provider Enumeration Date:
07/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COUNTRYMAN
Authorized Official First Name:
NADINE
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
641-472-4464

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0674036 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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