1417395740 NPI number — J&D NURSING MANAGEMENT

Table of content: (NPI 1417395740)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417395740 NPI number — J&D NURSING MANAGEMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
J&D NURSING MANAGEMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417395740
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/09/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4951 COLUMBIA RD APT I
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21044-1666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-593-1179
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4951 COLUMBIA RD
Provider Second Line Business Practice Location Address:
APT T1
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21044-1562
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-593-1179
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/09/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BRUCE
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
A
Authorized Official Title or Position:
REGISTERED NURSE
Authorized Official Telephone Number:
240-593-1179

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , with the licence number:  RN1030226 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)