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General NPI Number Information
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NPI Number | 1942554357
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Entity Type | Organization
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Legal Business Name | TEAM NURSE INC
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Dates
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Enumeration Date | 11/07/2012
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 621 BROAD ST SUITE 1
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City | ALTAVISTA
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State | VA
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Zip | 24517-1829
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Country | US
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Telephone | 434-309-2647
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Fax | 434-309-2642
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Provider Business Mailing Address
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Address Line | 621 BROAD ST SUITE 1
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City | ALTAVISTA
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State | VA
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Zip | 24517-1829
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Country | US
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Telephone | 434-309-2647
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Fax | 434-309-2642
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CHRISTY M GLYNN
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Credential |
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Telephone | 434-575-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC2100X
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Taxonomy Name | Continence Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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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 |
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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