Provider Demographics
NPI:1619140514
Name:HEALTHY HEART NURSE INC
Entity Type:Organization
Organization Name:HEALTHY HEART NURSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:N
Authorized Official - Last Name:ONYENSO
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:708-367-1300
Mailing Address - Street 1:1299 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:IL
Mailing Address - Zip Code:60417-2121
Mailing Address - Country:US
Mailing Address - Phone:708-367-1300
Mailing Address - Fax:708-367-1311
Practice Address - Street 1:1299 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:IL
Practice Address - Zip Code:60417
Practice Address - Country:US
Practice Address - Phone:708-367-1300
Practice Address - Fax:708-367-1311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility