Provider Demographics
NPI:1427204718
Name:TEAM NURSING INC
Entity Type:Organization
Organization Name:TEAM NURSING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-742-8694
Mailing Address - Street 1:6561 SUNSET STRIP
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33313-2838
Mailing Address - Country:US
Mailing Address - Phone:954-742-8694
Mailing Address - Fax:954-742-5904
Practice Address - Street 1:6561 SUNSET STRIP
Practice Address - Street 2:SUITE 101
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313-2838
Practice Address - Country:US
Practice Address - Phone:954-742-8694
Practice Address - Fax:954-742-5904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991540251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299991540OtherSTATE LICENSE