Healthcare Provider Details

I. General information

NPI: 1942384029
Provider Name (Legal Business Name): PROFESSIONAL NURSING SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 N 35TH ST
MOREHEAD CITY NC
28557-3104
US

IV. Provider business mailing address

212 N 35TH ST
MOREHEAD CITY NC
28557-3104
US

V. Phone/Fax

Practice location:
  • Phone: 252-247-6911
  • Fax: 252-247-1034
Mailing address:
  • Phone: 252-247-6911
  • Fax: 252-247-1034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. BETTY WOOLARD WALLACE
Title or Position: CEO
Credential: RN
Phone: 252-247-6911