MEDICARE: YOUR NURSE HOME HEALTH CARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	41534000	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003814377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUR NURSE HOME HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	6525 W BLUEMOUND RD STE 32
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53213-4073
Country	:	US
Telephone Number	:	414-774-9400
Fax Number	:	414-774-9432

Provider Business Practice Location Address
First Line	:	6525 W BLUEMOUND RD STE 32
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53213-4073
Country	:	US
Telephone Number	:	414-774-9400
Fax Number	:	414-774-9432

Authorized Official
Title or Position	:	OWNER
Name	:	MR. BRENT DUCHEMIN
Credential	:	RN
Telephone Number	:	414-774-9400

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	06/05/2019

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