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General NPI Number Information
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NPI Number | 1962823716
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Entity Type | Organization
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Legal Business Name | WELLNESS CARE NURSE REGISTRY INC
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Dates
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Enumeration Date | 12/20/2013
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Last Update Date | 12/20/2013
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Provider Practice Location Address
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Address Line | 3305 35TH ST SW
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City | LEHIGH ACRES
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State | FL
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Zip | 33976-4305
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Country | US
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Telephone | 239-645-4764
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Fax | 239-303-2859
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Provider Business Mailing Address
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Address Line | 3305 35TH ST SW
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City | LEHIGH ACRES
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State | FL
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Zip | 33976-4305
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Country | US
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Telephone | 239-645-4764
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Fax | 239-303-2859
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LAING BEVERLY
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Credential | RN
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Telephone | 239-645-4764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 30211684
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License Number State | FL
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