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General NPI Number Information
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NPI Number | 1871084467
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Entity Type | Organization
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Legal Business Name | NURTURECARE HEALTH LLC
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Dates
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Enumeration Date | 05/20/2018
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 14308 MINERVA AVE
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City | DOLTON
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State | IL
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Zip | 60419-1343
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Country | US
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Telephone | 708-953-5192
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Fax |
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Provider Business Mailing Address
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Address Line | 155 HARVEY DR
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City | WATERLOO
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State | IA
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Zip | 50701-2313
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Country | US
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Telephone | 708-953-5192
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Fax | 318-252-4687
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Authorized Official
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Title or Position | ADVANCED PRACTICE NURSE
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Name | LESLIE S WILLIAMS
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Credential | FNP
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Telephone | 708-953-5192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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