Provider Demographics
NPI:1023452505
Name:COMPASSIONATE CARE NURSING LLC
Entity type:Organization
Organization Name:COMPASSIONATE CARE NURSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHELYRIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:601-316-5908
Mailing Address - Street 1:231 FORBES CV
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39272-9178
Mailing Address - Country:US
Mailing Address - Phone:769-257-6879
Mailing Address - Fax:769-257-6879
Practice Address - Street 1:231 FORBES CV
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39272-9178
Practice Address - Country:US
Practice Address - Phone:769-257-6879
Practice Address - Fax:769-257-6879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP326161164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty