Provider Demographics
NPI:1962890046
Name:PREMIER NURSECARE SOLUTIONS
Entity type:Organization
Organization Name:PREMIER NURSECARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LATRINA
Authorized Official - Middle Name:COLLEEN
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN-BSN
Authorized Official - Phone:919-389-1891
Mailing Address - Street 1:4922 WINDY HILL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5195
Mailing Address - Country:US
Mailing Address - Phone:919-389-1891
Mailing Address - Fax:800-747-6905
Practice Address - Street 1:4922 WINDY HILL DR
Practice Address - Street 2:SUITE A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5195
Practice Address - Country:US
Practice Address - Phone:919-389-1891
Practice Address - Fax:800-747-6905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-24
Last Update Date:2014-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC210120251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care