Provider Demographics
NPI:1821448531
Name:PEDIATRIC NURSE CONSULTING
Entity Type:Organization
Organization Name:PEDIATRIC NURSE CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRUMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:407-592-6298
Mailing Address - Street 1:2913 CULLEN LAKE SHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-1038
Mailing Address - Country:US
Mailing Address - Phone:407-592-6298
Mailing Address - Fax:407-286-0724
Practice Address - Street 1:2913 CULLEN LAKE SHORE DRIVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-1038
Practice Address - Country:US
Practice Address - Phone:407-592-6298
Practice Address - Fax:407-286-0724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2662202251E00000X, 251F00000X, 251J00000X, 251K00000X, 251S00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care