Healthcare Provider Details

I. General information

NPI: 1962652347
Provider Name (Legal Business Name): PROFESSIONAL NURSING CONSULTANT SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 03/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8778 S. MARYLAND PKWY SUITE 105
LAS VEGAS NV
89123-6705
US

IV. Provider business mailing address

8778 S. MARYLAND PKWY SUITE 105
LAS VEGAS NV
89123-6705
US

V. Phone/Fax

Practice location:
  • Phone: 702-218-6425
  • Fax: 800-233-7048
Mailing address:
  • Phone: 702-218-6425
  • Fax: 800-233-7048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN31167
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN26555
License Number StateNV

VIII. Authorized Official

Name: MR. KENNETH ROGER CHAPMAN JR.
Title or Position: OWNER/MANAGER
Credential: RN
Phone: 702-279-5641