Healthcare Provider Details

I. General information

NPI: 1306718556
Provider Name (Legal Business Name): BERNADETTE VACHA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 WOOLWORTH AVE
OMAHA NE
68105-1850
US

IV. Provider business mailing address

7810 N 154TH ST
BENNINGTON NE
68007-1847
US

V. Phone/Fax

Practice location:
  • Phone: 402-995-4276
  • Fax:
Mailing address:
  • Phone: 402-995-4276
  • Fax: 402-995-5645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number64441
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: