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General NPI Number Information
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NPI Number | 1861429383
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Entity Type | Organization
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Legal Business Name | JERNIGAN NURSING HOME SERVICES INC
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 812 SHEPARD ST
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City | MOREHEAD CITY
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State | NC
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Zip | 28557-4250
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Country | US
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Telephone | 252-726-6855
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Fax | 252-808-2074
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Provider Business Mailing Address
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Address Line | 812 SHEPARD ST
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City | MOREHEAD CITY
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State | NC
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Zip | 28557-4250
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Country | US
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Telephone | 252-726-6855
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Fax | 252-808-2074
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. KAYE R JERNIGAN
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Credential |
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Telephone | 252-726-6855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | NH0255
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License Number State | NC
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