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General NPI Number Information
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NPI Number | 1558962068
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Entity Type | Organization
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Legal Business Name | NURSE NEXT DOOR, FISHERS
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 11814 WEDGEPORT LN
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City | FISHERS
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State | IN
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Zip | 46037-7983
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Country | US
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Telephone | 619-206-3230
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Fax |
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Provider Business Mailing Address
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Address Line | 11814 WEDGEPORT LN
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City | FISHERS
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State | IN
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Zip | 46037-7983
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Country | US
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Telephone | 619-206-3230
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Fax |
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Authorized Official
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Title or Position | CARE DESIGNER
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Name | ALEEZA GOGGINS
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Credential | LPN
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Telephone | 619-206-3230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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