Provider Demographics
NPI:1356708267
Name:NURSE KCARE TEAM
Entity type:Organization
Organization Name:NURSE KCARE TEAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:KALEECA
Authorized Official - Middle Name:TANIYA
Authorized Official - Last Name:BIBLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN PHN
Authorized Official - Phone:612-741-6474
Mailing Address - Street 1:3709 5TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1330
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3709 5TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-1330
Practice Address - Country:US
Practice Address - Phone:612-741-6474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 184152-7251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care