Healthcare Provider Details

I. General information

NPI: 1023275336
Provider Name (Legal Business Name): NIGHTINGALE WINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 03/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 KRONPRINDSENS GADE SUITE 205
CHARLOTTE AMALIE VI
00802
US

IV. Provider business mailing address

PO BOX 306916
ST THOMAS VI
00803-6916
US

V. Phone/Fax

Practice location:
  • Phone: 340-715-5333
  • Fax:
Mailing address:
  • Phone: 340-715-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number110051812007
License Number StateVI

VIII. Authorized Official

Name: MRS. LINDA C WEBBE
Title or Position: OWNER
Credential:
Phone: 340-715-5333