Provider Demographics
NPI:1306017470
Name:TEAM NURSE,INC.
Entity type:Organization
Organization Name:TEAM NURSE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MIZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-575-5200
Mailing Address - Street 1:1012 RESERVOIR ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-4457
Mailing Address - Country:US
Mailing Address - Phone:540-437-9978
Mailing Address - Fax:540-574-9951
Practice Address - Street 1:1012 RESERVOIR ST
Practice Address - Street 2:SUITE A
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-4457
Practice Address - Country:US
Practice Address - Phone:540-574-4321
Practice Address - Fax:540-437-9983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-10490251E00000X
385H00000X, 163WC2100X, 251B00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
No163WC2100XNursing Service ProvidersRegistered NurseContinence CareGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1306017470OtherPRIVATE DUTY MEDICAID
VA0153794646Medicaid
VA0153795023Medicaid
VAHCO-09490OtherSTATE LICENSURE