MEDICARE: NURSE NICOLES TRANSPORTATION SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	342000000X	Transportation Network Company
2	347C00000X	Private Vehicle
3	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1861240681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURSE NICOLES TRANSPORTATION SERVICES

Provider Business Mailing Address
First Line	:	2545 BELLWOOD RD
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23237-4472
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2545 BELLWOOD RD
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23237-4472
Country	:	US
Telephone Number	:	804-731-4590
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NICOLE BROWN
Credential	:
Telephone Number	:	804-731-4590

Provider Enumeration Date	:	05/07/2024
Last Update Date	:	05/07/2024

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