Provider Demographics
NPI:1467845354
Name:NURSE2ULLC
Entity Type:Organization
Organization Name:NURSE2ULLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PRECIOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:DESHIELD-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-578-0019
Mailing Address - Street 1:14601 BELLAIRE BLVD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-2505
Mailing Address - Country:US
Mailing Address - Phone:281-578-0019
Mailing Address - Fax:
Practice Address - Street 1:14601 BELLAIRE BLVD
Practice Address - Street 2:SUITE 145
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-2505
Practice Address - Country:US
Practice Address - Phone:281-578-0019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011330251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747364Medicare Oscar/Certification