Provider Demographics
NPI:1639661937
Name:PREMIER MOBILE HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:PREMIER MOBILE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NADINE-ANN
Authorized Official - Middle Name:ORINTHEA
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:239-222-1829
Mailing Address - Street 1:10676 COLONIAL BLVD STE 20
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8715
Mailing Address - Country:US
Mailing Address - Phone:239-222-1829
Mailing Address - Fax:239-294-3637
Practice Address - Street 1:10676 COLONIAL BLVD STE 20
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8715
Practice Address - Country:US
Practice Address - Phone:239-222-1829
Practice Address - Fax:239-443-4516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-01
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261Q00000X
FLARNP9276797363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty