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NPI 1174608889

NPI 1174608889 : TEAM NURSE, INC. : SOUTH BOSTON, VA

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General NPI Number Information
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    NPI Number           |    1174608889
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    Entity Type          |    Organization 
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    Legal Business Name  |    TEAM NURSE, INC. 
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Dates
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    Enumeration Date     |    10/25/2006
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    Last Update Date     |    03/08/2023
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Provider Practice Location Address
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    Address Line         |    3352 HALIFAX RD 
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    City                 |    SOUTH BOSTON
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    State                |    VA
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    Zip                  |    24592-4842
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    Country              |    US
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    Telephone            |    434-517-0050
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    Fax                  |    434-517-0049
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Provider Business Mailing Address
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    Address Line         |    PO BOX 776 
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    City                 |    SOUTH BOSTON
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    State                |    VA
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    Zip                  |    24592-0776
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    Country              |    US
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    Telephone            |    434-575-5200
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    Fax                  |    434-575-5204
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Authorized Official
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    Title or Position    |    SR ACCOUNTING MANAGER
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    Name                 |     ASHLEY  ROYSTER 
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    Credential           |    
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    Telephone            |    804-323-9464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    385H00000X
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    Taxonomy Name        |    Respite Care
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    163WC2100X
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    Taxonomy Name        |    Continence Care Registered Nurse
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    251B00000X
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    Taxonomy Name        |    Case Management Agency
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    HCO-0992
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    License Number State |    VA
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Taxonomy #5
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    Taxonomy Code        |    3747P1801X
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    Taxonomy Name        |    Personal Care Attendant
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    License Number       |    
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    License Number State |    
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