MEDICARE: MAY SUN HOME HEALTH NURSES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1568163574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAY SUN HOME HEALTH NURSES, PLLC

Provider Business Mailing Address
First Line	:	5540 CENTERVIEW DR STE 204
Second Line	:	PMB 787260
City	:	RALEIGH
State	:	NC
Zip	:	27606-8012
Country	:	US
Telephone Number	:	619-857-0248
Fax Number	:

Provider Business Practice Location Address
First Line	:	2689 NINFIELD DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-6989
Country	:	US
Telephone Number	:	619-857-0248
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ESTELLA G CHISHOLM
Credential	:	RN BSN MHA
Telephone Number	:	619-857-0248

Provider Enumeration Date	:	03/15/2023
Last Update Date	:	03/15/2023

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