=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629911441
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NICKERSON VOLUNTEER FIRE DEPARTMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2026
-----------------------------------------------------
Last Update Date | 04/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 N MAPLE ST
-----------------------------------------------------
City | NICKERSON
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68044-1001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-218-4392
-----------------------------------------------------
Fax | 877-343-0131
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10802 FARNAM DR
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68154-3237
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-218-4392
-----------------------------------------------------
Fax | 877-343-0131
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY / TREASURER
-----------------------------------------------------
Name | JASMINE DELUNA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 531-895-5853
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------