Provider Demographics
NPI:1275213506
Name:NURSE WIN LLC
Entity type:Organization
Organization Name:NURSE WIN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALOCCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-618-5760
Mailing Address - Street 1:2999 N 44TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7247
Mailing Address - Country:US
Mailing Address - Phone:480-618-5760
Mailing Address - Fax:602-253-5656
Practice Address - Street 1:12461 VETERANS MEMORIAL HWY STE 590
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-2025
Practice Address - Country:US
Practice Address - Phone:678-562-0086
Practice Address - Fax:678-562-0311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health