MEDICARE: ELIZABETH NURSE STAFFING INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency
2	251E00000X	Home Health Agency		GA

General Provider Information

NPI Number	:	1932415197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZABETH NURSE STAFFING INC

Provider Business Mailing Address
First Line	:	210 S PLEASANT ST APT 116
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64050-3635
Country	:	US
Telephone Number	:	404-583-3953
Fax Number	:

Provider Business Practice Location Address
First Line	:	830 BOULEVARD SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-3653
Country	:	US
Telephone Number	:	404-583-3953
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. CLATRES SHAUNTA BROWNLEE
Credential	:
Telephone Number	:	404-583-3953

Provider Enumeration Date	:	08/26/2010
Last Update Date	:	08/26/2010

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