Provider Demographics
NPI:1790808053
Name:EMERGENCY NURSING REGISTRY, INC.
Entity Type:Organization
Organization Name:EMERGENCY NURSING REGISTRY, INC.
Other - Org Name:ENR
Other - Org Type:Other Name
Authorized Official - Title/Position:CRITICAL CARE TRANSPORT COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSUE
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:HUEZO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:323-806-9827
Mailing Address - Street 1:37030 BOXLEAF RD
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-7360
Mailing Address - Country:US
Mailing Address - Phone:323-806-9827
Mailing Address - Fax:661-947-8620
Practice Address - Street 1:37030 BOXLEAF RD
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-7360
Practice Address - Country:US
Practice Address - Phone:323-806-9827
Practice Address - Fax:661-947-8620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN597688251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care