Provider Demographics
NPI:1558962068
Name:NURSE NEXT DOOR, FISHERS
Entity Type:Organization
Organization Name:NURSE NEXT DOOR, FISHERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE DESIGNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEEZA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:619-206-3230
Mailing Address - Street 1:11814 WEDGEPORT LN
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7983
Mailing Address - Country:US
Mailing Address - Phone:619-206-3230
Mailing Address - Fax:
Practice Address - Street 1:11814 WEDGEPORT LN
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7983
Practice Address - Country:US
Practice Address - Phone:619-206-3230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health