Healthcare Provider Details

I. General information

NPI: 1508971086
Provider Name (Legal Business Name): PROFESSIONAL NURSES SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 10/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 KIMBALL AVE SUITE 250
SOUTH BURLINGTON VT
05403-6833
US

IV. Provider business mailing address

110 KIMBALL AVE SUITE 250
SOUTH BURLINGTON VT
05403-6833
US

V. Phone/Fax

Practice location:
  • Phone: 800-446-8773
  • Fax: 802-861-2921
Mailing address:
  • Phone: 800-446-8773
  • Fax: 802-861-2921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number3747P1801X
License Number StateVT

VIII. Authorized Official

Name: JEAN P MCHENRY
Title or Position: PRESIDENT/CEO
Credential: R.N.
Phone: 800-446-8773