Healthcare Provider Details

I. General information

NPI: 1346697638
Provider Name (Legal Business Name): TRAVELING ANGELS NURSING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 LEE ROAD 2193
CUSSETA AL
36852-2827
US

IV. Provider business mailing address

2 LEE RD 2193
CUSSETA AL
36852
US

V. Phone/Fax

Practice location:
  • Phone: 334-332-3845
  • Fax:
Mailing address:
  • Phone: 334-332-3845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATINA LUSHONDA DRIVER
Title or Position: MANAGER
Credential:
Phone: 334-332-3845