=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578730107
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STAFFING NURSES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/13/2008
-----------------------------------------------------
Last Update Date | 06/05/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 S BRYAN BELT LINE RD SUITE A
-----------------------------------------------------
City | MESQUITE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75149-5000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-726-0062
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 S BRYAN BELT LINE RD SUITE A
-----------------------------------------------------
City | MESQUITE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75149-5000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-726-0062
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/ OWNER
-----------------------------------------------------
Name | MR. MIGUEL HERNANDEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 469-726-0062
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number | 010841
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------