Provider Demographics
NPI:1265696355
Name:NURSES NOOK
Entity type:Organization
Organization Name:NURSES NOOK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOCK
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:520-901-6587
Mailing Address - Street 1:4024 LA LINDA WAY
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-4602
Mailing Address - Country:US
Mailing Address - Phone:520-335-6680
Mailing Address - Fax:520-335-6681
Practice Address - Street 1:4024 E LA LINDA WAY
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-4602
Practice Address - Country:US
Practice Address - Phone:520-335-6680
Practice Address - Fax:520-335-6681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ433190Medicaid
AZ534000OtherJOINT COMMISSION