=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699488239
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARING AND COMPASSIONATE HEALTHCARE SERVICES, L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/28/2022
-----------------------------------------------------
Last Update Date | 12/28/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9043 LONGSTONE DR
-----------------------------------------------------
City | LEWIS CENTER
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43035-8439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-785-6838
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9043 LONGSTONE DR
-----------------------------------------------------
City | LEWIS CENTER
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43035-8439
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 161-478-5683
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADVANCED PRACTICE REGISTERED NURSE
-----------------------------------------------------
Name | MARTHA DIANN CLIFFORD
-----------------------------------------------------
Credential | A.P.R.N.-C.N.P.
-----------------------------------------------------
Telephone | 740-879-9222
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------