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General NPI Number Information
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NPI Number | 1497928717
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Entity Type | Organization
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Legal Business Name | SOUTHERN PROFESSIOANL MEDICAL STAFFING
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 9308 CHESAPEAKE DR
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City | BRENTWOOD
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State | TN
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Zip | 37027-7458
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Country | US
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Telephone | 615-585-8782
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Fax |
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Provider Business Mailing Address
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Address Line | 9308 CHESAPEAKE DR
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City | BRENTWOOD
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State | TN
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Zip | 37027-7458
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Country | US
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Telephone | 615-585-8782
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFF CHRISTIE
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Credential |
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Telephone | 615-585-8782
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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 | 0526612
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License Number State | TN
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