Provider Demographics
NPI:1578614251
Name:NURSEPRO NURSING SERVICES
Entity Type:Organization
Organization Name:NURSEPRO NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BS, BSN
Authorized Official - Phone:989-682-4037
Mailing Address - Street 1:6694 N FOREST HILL RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879-9731
Mailing Address - Country:US
Mailing Address - Phone:989-682-4037
Mailing Address - Fax:989-682-4037
Practice Address - Street 1:6694 N FOREST HILL RD
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-9731
Practice Address - Country:US
Practice Address - Phone:989-682-4037
Practice Address - Fax:989-682-4037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704158350163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0004359129Medicaid