Healthcare Provider Details

I. General information

NPI: 1467045039
Provider Name (Legal Business Name): NANA'S HOMEMAKER COMPANION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2021
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 MILLARD ST
TALLAHASSEE FL
32301-7038
US

IV. Provider business mailing address

716 MILLARD ST
TALLAHASSEE FL
32301-7038
US

V. Phone/Fax

Practice location:
  • Phone: 850-591-4981
  • Fax:
Mailing address:
  • Phone: 850-591-4981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TINA M HOLLIE
Title or Position: DIRECTOR
Credential: RN
Phone: 850-591-4981