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NPI Code Detail

MEDICARE: SPIRIT OF LIFE NURSE SOLUTIONS, PLLC

MEDICARE: SPIRIT OF LIFE NURSE SOLUTIONS, 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
1163WA2000XAdministrator Registered Nurse
2251J00000XNursing Care Agency
3251K00000XPublic Health or Welfare Agency
4251E00000XHome Health Agency

General Provider Information

NPI Number : 1578211413
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPIRIT OF LIFE NURSE SOLUTIONS, PLLC
Provider Business Mailing Address
First Line : 13331 VETERANS MEMORIAL DR STE G
Second Line :
City : HOUSTON
State : TX
Zip : 77014-1610
Country : US
Telephone Number : 346-291-0366
Fax Number : 346-273-2168
Provider Business Practice Location Address
First Line : 13331 VETERANS MEMORIAL DR STE G
Second Line :
City : HOUSTON
State : TX
Zip : 77014-1610
Country : US
Telephone Number : 346-291-0366
Fax Number : 346-273-2168
Authorized Official
Title or Position : CO-OWNER
Name : KENNETH MAXIE JACKSON
Credential :
Telephone Number : 346-291-0366
Provider Enumeration Date : 03/10/2022
Last Update Date : 03/10/2022

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