Healthcare Provider Details

I. General information

NPI: 1487450581
Provider Name (Legal Business Name): NURSEFULLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11914 TRES BISPOS AVE
LAS VEGAS NV
89138-3025
US

IV. Provider business mailing address

254 CHAPMAN RD STE 209
NEWARK DE
19702-5422
US

V. Phone/Fax

Practice location:
  • Phone: 917-796-1902
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY CHOW
Title or Position: CO-FOUNDER, CEO
Credential: DNP, NP, RN
Phone: 917-796-1902