Provider Demographics
NPI:1932196136
Name:VISITING NURSE ASSOCIATION OF ERIE COUNTY
Entity type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF ERIE COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:N
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:814-454-2831
Mailing Address - Street 1:2253 W GRANDVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4507
Mailing Address - Country:US
Mailing Address - Phone:814-454-2831
Mailing Address - Fax:814-453-5357
Practice Address - Street 1:2253 W GRANDVIEW BLVD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4507
Practice Address - Country:US
Practice Address - Phone:814-454-2831
Practice Address - Fax:814-453-5357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA703405251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0709828Medicaid
PA397034Medicare ID - Type UnspecifiedHOME HEALTH CARE