Provider Demographics
NPI:1295337772
Name:LIVING WATER NURSE CONSULTING AND COACHING SERVICES
Entity type:Organization
Organization Name:LIVING WATER NURSE CONSULTING AND COACHING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANTELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SADBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:817-726-5029
Mailing Address - Street 1:550 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 2751
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070
Mailing Address - Country:US
Mailing Address - Phone:817-470-2633
Mailing Address - Fax:
Practice Address - Street 1:15922 EL DORADO PARKWAY
Practice Address - Street 2:#500 #578
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035
Practice Address - Country:US
Practice Address - Phone:817-470-2633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management