Organization Name: | CLEVELAND VA CBOC |
NPI Number: | 1063439966 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STACEY JEAN HIBBARD (LPN) |
Mailing Address: | 1205 North Ave Cleveland |
State: | WI US |
Postal Code: | 530151413 |
Phone Number: | 1888469661 |
Fax Number: | |
NPI Enumeration Date: | 07/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 18107-031 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |