Provider Demographics
NPI:1952052672
Name:NURSE ON THE GO LLC
Entity Type:Organization
Organization Name:NURSE ON THE GO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:901-517-8678
Mailing Address - Street 1:1748 WOOTEN DR
Mailing Address - Street 2:
Mailing Address - City:NESBIT
Mailing Address - State:MS
Mailing Address - Zip Code:38651-2301
Mailing Address - Country:US
Mailing Address - Phone:901-517-8678
Mailing Address - Fax:
Practice Address - Street 1:1748 WOOTEN DR
Practice Address - Street 2:
Practice Address - City:NESBIT
Practice Address - State:MS
Practice Address - Zip Code:38651-2301
Practice Address - Country:US
Practice Address - Phone:901-517-8678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty