Provider Demographics
NPI:1528318706
Name:NATIONS CARE LINK
Entity type:Organization
Organization Name:NATIONS CARE LINK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:REAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-922-8942
Mailing Address - Street 1:11000 PRAIRIE LAKES DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3885
Mailing Address - Country:US
Mailing Address - Phone:952-914-2400
Mailing Address - Fax:952-833-5489
Practice Address - Street 1:11000 PRAIRIE LAKES DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3885
Practice Address - Country:US
Practice Address - Phone:952-914-2400
Practice Address - Fax:952-833-5489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty