MEDICARE: EXCEPTIONAL NURSING SERVICES

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	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1952082885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCEPTIONAL NURSING SERVICES

Provider Business Mailing Address
First Line	:	9530 SEDALIA ST
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-7227
Country	:	US
Telephone Number	:	303-980-0015
Fax Number	:

Provider Business Practice Location Address
First Line	:	9530 SEDALIA ST
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-7227
Country	:	US
Telephone Number	:	303-980-0015
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BROOKE GORDON
Credential	:	RN BSN
Telephone Number	:	303-980-0015

Provider Enumeration Date	:	07/25/2023
Last Update Date	:	07/25/2023

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