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General NPI Number Information
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NPI Number | 1801134648
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Entity Type | Organization
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Legal Business Name | JUST ONE NURSE
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Dates
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Enumeration Date | 01/29/2013
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 5425 WYNNEFIELD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19131-1323
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Country | US
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Telephone | 888-791-9145
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Fax |
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Provider Business Mailing Address
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Address Line | 5425 WYNNEFIELD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19131-1323
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Country | US
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Telephone | 888-791-9145
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR-DIRECTOR OF NURSING
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Name | MRS. TAMIKA D BUTTS
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Credential | RN MSN
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Telephone | 267-246-3222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 4151228
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License Number State | PA
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