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General NPI Number Information
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NPI Number | 1790441004
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Entity Type | Organization
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Legal Business Name | NANCYS FAMILY HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 2751 PATTERSON ST # 105
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City | GREENSBORO
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State | NC
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Zip | 27407-2336
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Country | US
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Telephone | 336-588-8268
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Fax |
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Provider Business Mailing Address
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Address Line | 1507 VANCE ST
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City | GREENSBORO
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State | NC
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Zip | 27406-2365
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STACEY NICKERSON
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Credential |
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Telephone | 336-588-8268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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