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General NPI Number Information
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NPI Number | 1932412582
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Entity Type | Organization
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Legal Business Name | NURSE SHARKS, INC.
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Dates
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Enumeration Date | 07/23/2010
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 661 BYRNEDALE RD
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City | WEEDVILLE
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State | PA
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Zip | 15868-1515
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Country | US
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Telephone | 814-787-7365
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Fax | 888-398-6221
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Provider Business Mailing Address
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Address Line | 405 SHERWOOD DR
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City | KITTANNING
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State | PA
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Zip | 16201-1973
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Country | US
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Telephone | 814-787-7365
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Fax | 888-398-6221
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JENNIFER KAY AGOSTI
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Credential | RN, CWCA, CFCN
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Telephone | 814-787-7365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | SP009869
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SP009869
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License Number State | PA
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