Provider Demographics
NPI:1275333536
Name:HARGENS, VANESSA (LPN)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:HARGENS
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-5829
Mailing Address - Country:US
Mailing Address - Phone:402-810-0585
Mailing Address - Fax:
Practice Address - Street 1:1409 BLUFF ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-5829
Practice Address - Country:US
Practice Address - Phone:402-810-0585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24535164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse