Provider Demographics
NPI:1841207024
Name:U.S. NAVY
Entity Type:Organization
Organization Name:U.S. NAVY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURCE
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:312-629-6150
Mailing Address - Street 1:PCS 827 BOX 79
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:FPO
Mailing Address - Zip Code:AE
Mailing Address - Country:IT
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PCS 827 BOX 79
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:NAPLES
Practice Address - Zip Code:AE
Practice Address - Country:IT
Practice Address - Phone:312-629-6150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK75619313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility