Healthcare Provider Details

I. General information

NPI: 1003514316
Provider Name (Legal Business Name): GOOD NEWS NURSE REGISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 TORREYA DR
TALLAHASSEE FL
32303-4222
US

IV. Provider business mailing address

4313 MAYLOR LN
TALLAHASSEE FL
32308-5773
US

V. Phone/Fax

Practice location:
  • Phone: 850-284-4660
  • Fax: 850-577-1311
Mailing address:
  • Phone: 850-284-4660
  • Fax: 850-577-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMUEL KOFI MENSAH-MAMFO
Title or Position: PRESIDENT
Credential:
Phone: 850-284-4660