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General NPI Number Information
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NPI Number | 1508579988
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Entity Type | Organization
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Legal Business Name | LEGENDARY MEDICAL STAFFING LLC
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Dates
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Enumeration Date | 01/02/2023
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Last Update Date | 01/02/2023
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Provider Practice Location Address
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Address Line | 9080 BARBEE LN STE 104B
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City | KNOXVILLE
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State | TN
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Zip | 37923-6256
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Country | US
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Telephone | 865-226-9679
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Fax | 865-273-0266
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Provider Business Mailing Address
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Address Line | 9080 BARBEE LN STE 104B
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City | KNOXVILLE
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State | TN
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Zip | 37923-6256
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Country | US
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Telephone | 865-226-9679
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Fax | 865-273-0266
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Authorized Official
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Title or Position | CEO
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Name | MRS. HEATHER WHITE
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Credential | RN
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Telephone | 865-226-9679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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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 | 372600000X
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Taxonomy Name | Adult Companion
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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 | 376J00000X
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Taxonomy Name | Homemaker
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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 | 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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