Provider Demographics
NPI:1033365499
Name:NURSE FACILITATORS, INC.
Entity Type:Organization
Organization Name:NURSE FACILITATORS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VIRGINIA WAIVER SERVICE FACILITATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:BURNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:434-728-0478
Mailing Address - Street 1:452 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-1893
Mailing Address - Country:US
Mailing Address - Phone:434-728-0478
Mailing Address - Fax:434-836-2826
Practice Address - Street 1:452 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-1893
Practice Address - Country:US
Practice Address - Phone:434-728-0478
Practice Address - Fax:434-836-2826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-15
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001093048251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAAPPLIEDMedicaid