Provider Demographics
NPI:1558614925
Name:PRN HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:PRN HEALTH SERVICES, INC.
Other - Org Name:NURSES PRN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HIETPAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-830-8811
Mailing Address - Street 1:4321 W COLLEGE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-3966
Mailing Address - Country:US
Mailing Address - Phone:888-830-8811
Mailing Address - Fax:
Practice Address - Street 1:4321 W COLLEGE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-3966
Practice Address - Country:US
Practice Address - Phone:888-830-8811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNP4272251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care