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General NPI Number Information
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NPI Number | 1679847248
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Entity Type | Organization
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Legal Business Name | VNA PRIVATE DUTY, LLC
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 7008 SECURITY BLVD SUITE 300
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City | BALTIMORE
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State | MD
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Zip | 21244-2566
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Country | US
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Telephone | 410-277-5920
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Fax | 410-753-1222
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Provider Business Mailing Address
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Address Line | 7008 SECURITY BLVD SUITE 300
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City | BALTIMORE
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State | MD
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Zip | 21244-2566
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Country | US
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Telephone | 410-277-5920
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Fax | 410-753-1222
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | MRS. TINA ANN NOWAKOWSKI
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Credential | RN
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Telephone | 443-506-0220
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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 | R3042
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License Number State | MD
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