Provider Demographics
NPI:1144433426
Name:PERSONAL NURSING CARE, INC
Entity type:Organization
Organization Name:PERSONAL NURSING CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS, CCM, CLNC
Authorized Official - Phone:405-752-5222
Mailing Address - Street 1:1240 NW 115TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-8003
Mailing Address - Country:US
Mailing Address - Phone:405-752-5222
Mailing Address - Fax:405-752-5246
Practice Address - Street 1:1240 NW 115TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-8003
Practice Address - Country:US
Practice Address - Phone:405-752-5222
Practice Address - Fax:405-752-5246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health