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General NPI Number Information
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NPI Number | 1881829190
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Entity Type | Organization
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Legal Business Name | KITTY LOUISE TRAVEL NURSE
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Dates
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Enumeration Date | 05/17/2009
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Last Update Date | 05/17/2009
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Provider Practice Location Address
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Address Line | 341 HIDDEN PINES CIR
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City | CASSELBERRY
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State | FL
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Zip | 32707-3361
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Country | US
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Telephone | 407-272-1526
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Fax |
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Provider Business Mailing Address
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Address Line | 341 HIDDEN PINES CIR
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City | CASSELBERRY
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State | FL
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Zip | 32707-3361
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Country | US
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Telephone | 407-272-1526
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Fax |
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Authorized Official
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Title or Position | CNA
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Name | ERICA LOUISE TATE
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Credential |
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Telephone | 407-272-1526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | CNA0304027
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | CNA0304027
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | CNA0304027
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License Number State | IN
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