MEDICARE: NICHOLAS VAVRINA

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	372500000X	Chore Provider
2	372600000X	Adult Companion

General Provider Information

NPI Number	:	1457159600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS VAVRINA

Provider Business Mailing Address
First Line	:	1911 S 50TH ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-2010
Country	:	US
Telephone Number	:	402-617-9142
Fax Number	:

Provider Business Practice Location Address
First Line	:	8055 O ST STE 119B
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68510-2565
Country	:	US
Telephone Number	:	402-421-1119
Fax Number	:	402-200-2306

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	03/04/2025

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Directions to “ NICHOLAS VAVRINA ” Practice Location

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