Provider Demographics
NPI:1265132500
Name:NIGHTINGALE HOME CARE
Entity type:Organization
Organization Name:NIGHTINGALE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:MARIANNE
Authorized Official - Last Name:KEEGSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:616-308-7959
Mailing Address - Street 1:2300 MAGUIRE AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-9604
Mailing Address - Country:US
Mailing Address - Phone:616-308-7959
Mailing Address - Fax:
Practice Address - Street 1:2300 MAGUIRE AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9604
Practice Address - Country:US
Practice Address - Phone:616-308-7959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing FacilityGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No251E00000XAgenciesHome Health