=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790565893
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HALO NURSES & ASSOCIATES, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2023
-----------------------------------------------------
Last Update Date | 10/05/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 323 CLIFTON ST STE 19
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27858-5053
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-553-5274
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1821 MIDGETTE LN
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27834-6672
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-314-9714
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL SERVICES DIRECTOR
-----------------------------------------------------
Name | MS. DEMEKA VINES PARAMORE
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 252-314-9714
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------