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General NPI Number Information
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NPI Number | 1699845610
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Entity Type | Organization
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Legal Business Name | HOME CARE NURSING, INC.
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 3370 DELASSUS RD
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City | FARMINGTON
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State | MO
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Zip | 63640-7001
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Country | US
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Telephone | 573-747-1678
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Fax | 573-747-0583
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Provider Business Mailing Address
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Address Line | 3370 DELASSUS RD
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City | FARMINGTON
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State | MO
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Zip | 63640-7001
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Country | US
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Telephone | 573-747-1678
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Fax | 573-747-0583
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUSAN LEA STOTZ
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Credential | RN
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Telephone | 573-747-1678
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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 | 005434
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License Number State | MO
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