Provider Demographics
NPI:1285838367
Name:NERKOWSKI, INC.
Entity Type:Organization
Organization Name:NERKOWSKI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:JO
Authorized Official - Last Name:NERKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-770-1687
Mailing Address - Street 1:608 BLUEBONNET DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-4429
Mailing Address - Country:US
Mailing Address - Phone:214-770-1687
Mailing Address - Fax:214-509-9776
Practice Address - Street 1:608 BLUEBONNET DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-4429
Practice Address - Country:US
Practice Address - Phone:214-770-1687
Practice Address - Fax:214-509-9776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001007822311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home