Provider Demographics
NPI:1285742866
Name:VERMAAS, PATRICIA L (APRN, BC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:VERMAAS
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67250
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506
Mailing Address - Country:US
Mailing Address - Phone:402-328-2907
Mailing Address - Fax:402-328-2907
Practice Address - Street 1:8511 AUGUSTA DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9572
Practice Address - Country:US
Practice Address - Phone:402-328-2907
Practice Address - Fax:888-965-0959
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110260363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0570077Medicaid
NE47084496100Medicaid
IA0570077Medicaid
NES65255Medicare UPIN
P00012794Medicare PIN