Healthcare Provider Details

I. General information

NPI: 1306990197
Provider Name (Legal Business Name): PRONURSE MEDICAL STAFFING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 S TRYON ST SUITE 106
CHARLOTTE NC
28203-4225
US

IV. Provider business mailing address

1014 S TRYON ST SUITE 106
CHARLOTTE NC
28203-4225
US

V. Phone/Fax

Practice location:
  • Phone: 704-347-4767
  • Fax: 704-347-4770
Mailing address:
  • Phone: 704-347-4767
  • Fax: 704-347-4770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberHC1855
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License NumberHC1855
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberHC1855
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberHC1855
License Number StateNC

VIII. Authorized Official

Name: MRS. THOMASINA SMITH LANEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 704-347-4767