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General NPI Number Information
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NPI Number | 1104062355
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Entity Type | Organization
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Legal Business Name | ELITE STAFFING GROUP FOR SURGICAL NURSES, LLC.
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Dates
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Enumeration Date | 12/17/2008
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Last Update Date | 12/17/2008
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Provider Practice Location Address
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Address Line | 500 W LANIER AVE SUITE 606A
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7636
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Country | US
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Telephone | 770-573-1876
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Fax | 770-252-1102
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Provider Business Mailing Address
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Address Line | 8376 CARLINGTON LN
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City | JONESBORO
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State | GA
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Zip | 30236-3769
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Country | US
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Telephone | 404-936-4936
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Fax | 770-252-1102
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Authorized Official
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Title or Position | CO-OWNER
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Name | MS. VANESSA J RAINEY
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Credential | CNP
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Telephone | 770-783-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 132138LGB
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License Number State | GA
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