=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255570107
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE NURTURING NURSE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2009
-----------------------------------------------------
Last Update Date | 02/17/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3113 W MARSHALL ST SUITE 107
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23230-4730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-243-4282
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 115 E 14TH ST
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23224-3930
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-243-4282
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. MELINDA NICOLE KING
-----------------------------------------------------
Credential | LPN
-----------------------------------------------------
Telephone | 804-243-4282
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | 0002073333
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------