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General NPI Number Information
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NPI Number | 1477277051
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Entity Type | Organization
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Legal Business Name | VITALITY MOBILE NURSING SERVICES LLC
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 11740 SW VILLAGE PKWY APT 307
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34987-2598
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Country | US
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Telephone | 772-249-6381
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Fax |
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Provider Business Mailing Address
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Address Line | 11740 SW VILLAGE PKWY APT 307
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34987-2598
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Country | US
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Telephone | 772-249-6381
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Fax |
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Authorized Official
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Title or Position | RN
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Name | NICOLE HALL HALL
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Credential |
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Telephone | 772-249-6381
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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