Provider Demographics
NPI:1275214769
Name:J.C.PRIVATE NURSING SERVICE
Entity Type:Organization
Organization Name:J.C.PRIVATE NURSING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:JUANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:239-476-2169
Mailing Address - Street 1:1008 ROBERT AVE
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-0913
Mailing Address - Country:US
Mailing Address - Phone:239-476-2169
Mailing Address - Fax:
Practice Address - Street 1:1008 ROBERT AVE
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-0913
Practice Address - Country:US
Practice Address - Phone:239-476-2169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-27
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health