Healthcare Provider Details

I. General information

NPI: 1255712063
Provider Name (Legal Business Name): NURSETREK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 W ELM ST #C
ROCKMART GA
30153-1727
US

IV. Provider business mailing address

826 W ELM ST #C
ROCKMART GA
30153
US

V. Phone/Fax

Practice location:
  • Phone: 404-920-9299
  • Fax: 678-685-6224
Mailing address:
  • Phone: 404-920-9299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. TERRIE LEANNE JANIS
Title or Position: OWNER
Credential: RN
Phone: 404-620-9299