Provider Demographics
NPI:1063084846
Name:SELECT NURSING LLC
Entity type:Organization
Organization Name:SELECT NURSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:KEEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:404-441-2394
Mailing Address - Street 1:4305 PAXTON LN SW APT 809
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-8401
Mailing Address - Country:US
Mailing Address - Phone:678-599-4051
Mailing Address - Fax:
Practice Address - Street 1:4305 PAXTON LN SW APT 809
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-8401
Practice Address - Country:US
Practice Address - Phone:678-599-4051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care