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General NPI Number Information
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NPI Number | 1912901703
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Entity Type | Organization
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Legal Business Name | WATERLOO VISITING NURSING ASSOCIATION
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2530 UNIVERSITY AVE STE 3
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City | WATERLOO
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State | IA
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Zip | 50701-3304
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Country | US
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Telephone | 319-235-6201
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Fax | 319-232-7296
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Provider Business Mailing Address
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Address Line | 2530 UNIVERSITY AVE STE 3
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City | WATERLOO
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State | IA
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Zip | 50701-3304
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Country | US
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Telephone | 319-235-6201
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Fax | 319-232-7296
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. MARY KATHRYN NICHOLAS
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Credential |
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Telephone | 319-235-6201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | IA
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