Provider Demographics
NPI:1265156699
Name:TIER 1 NURSING LLC
Entity type:Organization
Organization Name:TIER 1 NURSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER LPN
Authorized Official - Prefix:
Authorized Official - First Name:STASIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:WYSOTE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:386-262-2968
Mailing Address - Street 1:1444 OKEECHOBEE RD LOT 30
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1444 OKEECHOBEE RD LOT 30
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-6805
Practice Address - Country:US
Practice Address - Phone:386-262-2968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health