MEDICARE: GLORIFIED NURSING LLC

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	251J00000X	Nursing Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1740947399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLORIFIED NURSING LLC

Provider Business Mailing Address
First Line	:	1821 SUMMIT RD STE 116
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-2818
Country	:	US
Telephone Number	:	513-376-9207
Fax Number	:

Provider Business Practice Location Address
First Line	:	1821 SUMMIT RD STE 116
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-2818
Country	:	US
Telephone Number	:	513-376-9207
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAMARA HUDSON
Credential	:	LPN
Telephone Number	:	513-376-9207

Provider Enumeration Date	:	11/18/2021
Last Update Date	:	06/15/2023

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Directions to “GLORIFIED NURSING LLC ” Practice Location

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