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General NPI Number Information
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NPI Number | 1649737537
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL RN SERVICES LLC
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Dates
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Enumeration Date | 02/27/2019
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 2375 S KNIGHTRIDGE RD
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City | BLOOMINGTON
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State | IN
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Zip | 47401-7835
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Country | US
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Telephone | 812-955-0905
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Fax |
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Provider Business Mailing Address
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Address Line | 2375 S KNIGHTRIDGE RD
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City | BLOOMINGTON
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State | IN
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Zip | 47401-7835
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Country | US
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Telephone | 812-955-0905
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CORRINE CARTER
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Credential | RN
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Telephone | 812-955-0905
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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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