Provider Demographics
NPI:1891483905
Name:XTRA MILES NURSING LLC
Entity Type:Organization
Organization Name:XTRA MILES NURSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:OMOLARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIBISALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-370-7509
Mailing Address - Street 1:3819 GAWAYNE TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2656
Mailing Address - Country:US
Mailing Address - Phone:240-370-7509
Mailing Address - Fax:240-363-8106
Practice Address - Street 1:3819 GAWAYNE TER
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2656
Practice Address - Country:US
Practice Address - Phone:240-370-7509
Practice Address - Fax:240-363-8106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty