Provider Demographics
NPI:1386159234
Name:PHOENIX NURSE MANAGEMENT CONSULTANTS
Entity type:Organization
Organization Name:PHOENIX NURSE MANAGEMENT CONSULTANTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:F
Authorized Official - Last Name:BURRIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:317-437-6511
Mailing Address - Street 1:3905 NUTHATCHER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46228-1095
Mailing Address - Country:US
Mailing Address - Phone:317-437-6511
Mailing Address - Fax:317-536-3256
Practice Address - Street 1:11903 E WELLAND ST STE D
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-3911
Practice Address - Country:US
Practice Address - Phone:800-925-6418
Practice Address - Fax:317-536-3256
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHOENIX NURSE MANAGEMENT CONSULTANTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17-014201-1253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care