Provider Demographics
NPI:1558016303
Name:WILLOW NURSING CONCIERGE
Entity Type:Organization
Organization Name:WILLOW NURSING CONCIERGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:INESHIA
Authorized Official - Middle Name:NECOLE
Authorized Official - Last Name:POTTS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:281-352-3455
Mailing Address - Street 1:2007 COMMERCE ST # 36
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-2313
Mailing Address - Country:US
Mailing Address - Phone:832-981-2777
Mailing Address - Fax:
Practice Address - Street 1:2007 COMMERCE ST # 36
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-2313
Practice Address - Country:US
Practice Address - Phone:346-345-5582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory