Provider Demographics
NPI:1194289041
Name:NIGHTINGALE HOME SERVICES
Entity type:Organization
Organization Name:NIGHTINGALE HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-885-2961
Mailing Address - Street 1:3127 SANTIAGO DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-2620
Mailing Address - Country:US
Mailing Address - Phone:314-885-2961
Mailing Address - Fax:
Practice Address - Street 1:3127 SANTIAGO DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-2620
Practice Address - Country:US
Practice Address - Phone:314-885-2961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health