Provider Demographics
NPI:1730745597
Name:WHOLEHEARTED HEALTHCARE PC
Entity type:Organization
Organization Name:WHOLEHEARTED HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EUGENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN FNP
Authorized Official - Phone:402-730-9819
Mailing Address - Street 1:4701 BANCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-4324
Mailing Address - Country:US
Mailing Address - Phone:402-730-9819
Mailing Address - Fax:308-870-7157
Practice Address - Street 1:4701 BANCROFT AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-4324
Practice Address - Country:US
Practice Address - Phone:402-730-9819
Practice Address - Fax:308-870-7157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care