Provider Demographics
NPI:1346434453
Name:BONNEVILLE HEALTH RECRUITERS DBA PROFESSIONAL NURSING SERVICE
Entity Type:Organization
Organization Name:BONNEVILLE HEALTH RECRUITERS DBA PROFESSIONAL NURSING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P.
Authorized Official - Prefix:MS
Authorized Official - First Name:VERA
Authorized Official - Middle Name:P
Authorized Official - Last Name:ANDRUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-446-4545
Mailing Address - Street 1:1196 W SOUTH JORDAN PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-4603
Mailing Address - Country:US
Mailing Address - Phone:801-446-4545
Mailing Address - Fax:801-446-4499
Practice Address - Street 1:1196 W SOUTH JORDAN PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-4603
Practice Address - Country:US
Practice Address - Phone:801-446-4545
Practice Address - Fax:801-446-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care