Provider Demographics
NPI:1861157349
Name:PRIME NURSE DELIGATION LLC
Entity type:Organization
Organization Name:PRIME NURSE DELIGATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEMAYEHU
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-372-3899
Mailing Address - Street 1:7314 68TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-7708
Mailing Address - Country:US
Mailing Address - Phone:847-372-3899
Mailing Address - Fax:206-260-2715
Practice Address - Street 1:7314 68TH AVE NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-7708
Practice Address - Country:US
Practice Address - Phone:847-372-3899
Practice Address - Fax:206-260-2715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty