Provider Demographics
NPI:1497820310
Name:NURSEMED LLC
Entity Type:Organization
Organization Name:NURSEMED LLC
Other - Org Name:NURSEMED 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:662-365-9305
Mailing Address - Street 1:1031 NORTHRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BALDWYN
Mailing Address - State:MS
Mailing Address - Zip Code:38824-1173
Mailing Address - Country:US
Mailing Address - Phone:662-365-9305
Mailing Address - Fax:662-365-9304
Practice Address - Street 1:1031 NORTHRIDGE RD
Practice Address - Street 2:
Practice Address - City:BALDWYN
Practice Address - State:MS
Practice Address - Zip Code:38824-1173
Practice Address - Country:US
Practice Address - Phone:662-365-9305
Practice Address - Fax:662-365-9304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR622176261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06403005Medicaid
MS258972Medicare ID - Type UnspecifiedRURAL HEALTH NUMBER