Provider Demographics
NPI:1205910981
Name:TEAM NURSE, INC.
Entity type:Organization
Organization Name:TEAM NURSE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR ACCOUNTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-323-9464
Mailing Address - Street 1:508 PINEY FOREST RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-3320
Mailing Address - Country:US
Mailing Address - Phone:434-575-5200
Mailing Address - Fax:434-575-5204
Practice Address - Street 1:508 PINEY FOREST RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-3320
Practice Address - Country:US
Practice Address - Phone:434-575-5200
Practice Address - Fax:434-575-5204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WC2100X, 251B00000X, 385H00000X, 3747P1801X
VAHCO-10148251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No163WC2100XNursing Service ProvidersRegistered NurseContinence CareGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0087041213Medicaid
VA1205910981OtherPRIVATE DUTY
VA0087721772Medicaid
VAHCO-09148OtherSTATE LICENSURE
VAML-171464OtherCOMMONWEALTH OF VA VDH
VA008751099OtherPRIVATE DUTY MEDICAID