Provider Demographics
NPI:1003311580
Name:NURSING DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:NURSING DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO - MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN, CCM
Authorized Official - Phone:478-442-3156
Mailing Address - Street 1:404 LAURIE LANE
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088
Mailing Address - Country:US
Mailing Address - Phone:478-442-3156
Mailing Address - Fax:
Practice Address - Street 1:312 N DAVIS DR
Practice Address - Street 2:#100
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093
Practice Address - Country:US
Practice Address - Phone:478-328-7975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN105510163W00000X, 163WN0800X, 261QR1300X, 261QV0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscienceGroup - Multi-Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVAGroup - Multi-Specialty