Healthcare Provider Details
I. General information
NPI: 1861151524
Provider Name (Legal Business Name): NURSETEL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/09/2021
Last Update Date: 12/09/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
263 WATERFORD COVE TRL
CALERA AL
35040-7625
US
IV. Provider business mailing address
PO BOX 590
MOBILE AL
36601-0590
US
V. Phone/Fax
- Phone: 205-664-9422
- Fax:
- Phone: 251-264-3009
- Fax: 251-973-8212
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332U00000X |
| Taxonomy | Home Delivered Meals |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHELIA
ANN
WHITE
Title or Position: ADMINISTRATOR
Credential:
Phone: 251-264-3009