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General NPI Number Information
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NPI Number | 1306471891
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Entity Type | Organization
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Legal Business Name | NP SERVICES AT HOME, LLC
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Dates
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Enumeration Date | 03/05/2020
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 30525 SW 193RD CT
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City | HOMESTEAD
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State | FL
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Zip | 33030-3656
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Country | US
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Telephone | 786-470-7728
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 900285
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City | HOMESTEAD
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State | FL
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Zip | 33090-0285
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NP
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Name | JOLENE HODGES
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Credential | NP
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Telephone | 786-470-7728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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