Provider Demographics
NPI:1659577971
Name:PROFESSIONAL NURSING, INC.
Entity Type:Organization
Organization Name:PROFESSIONAL NURSING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VARDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YERKARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-955-5848
Mailing Address - Street 1:2110 N GLENOAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2827
Mailing Address - Country:US
Mailing Address - Phone:818-955-5848
Mailing Address - Fax:818-955-5870
Practice Address - Street 1:2110 N GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-2827
Practice Address - Country:US
Practice Address - Phone:818-955-5848
Practice Address - Fax:818-955-5870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-24
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000933251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059161Medicare Oscar/Certification