Provider Demographics
NPI:1568977593
Name:MPS HEALTHCARE
Entity Type:Organization
Organization Name:MPS HEALTHCARE
Other - Org Name:CONTINUUM PEDIATRIC NURSING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NATIONAL DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-506-0123
Mailing Address - Street 1:1651 OLD MEADOW RD STE 600
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-4389
Mailing Address - Country:US
Mailing Address - Phone:703-506-0123
Mailing Address - Fax:703-734-1932
Practice Address - Street 1:1651 OLD MEADOW RD STE 600
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4389
Practice Address - Country:US
Practice Address - Phone:703-506-0123
Practice Address - Fax:703-734-1932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001142058163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1689638488Medicaid