Healthcare Provider Details

I. General information

NPI: 1457874521
Provider Name (Legal Business Name): COMPASSION MEDICAL STAFFING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 07/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 WALL ST. SUITE 8
COLUMBIA LA
71418
US

IV. Provider business mailing address

P.O. BOX 37 199 GIBSON
CLARKS LA
71415
US

V. Phone/Fax

Practice location:
  • Phone: 318-381-3052
  • Fax:
Mailing address:
  • Phone: 318-381-3052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANDREA MARIE JORDAN
Title or Position: PRESIDENT-OWNER
Credential:
Phone: 318-381-3052