Provider Demographics
NPI:1720815574
Name:MY FRIEND'S A NURSE, PC
Entity type:Organization
Organization Name:MY FRIEND'S A NURSE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGHOLIKAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-919-0152
Mailing Address - Street 1:1564 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3974
Mailing Address - Country:US
Mailing Address - Phone:818-919-0152
Mailing Address - Fax:
Practice Address - Street 1:1564 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3974
Practice Address - Country:US
Practice Address - Phone:818-919-0152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty