Healthcare Provider Details

I. General information

NPI: 1417611658
Provider Name (Legal Business Name): NURSE WARREN HEALTHCARE CONSULTING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4752 HIGHPOINT WAY
ATLANTA GA
30349-1972
US

IV. Provider business mailing address

4752 HIGHPOINT WAY
ATLANTA GA
30349-1972
US

V. Phone/Fax

Practice location:
  • Phone: 504-812-1344
  • Fax:
Mailing address:
  • Phone: 504-812-1344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: JACQUELINE SERVICES WARREN
Title or Position: OWNER/MANAGER
Credential:
Phone: 504-812-1344