Provider Demographics
NPI:1831710722
Name:NURSES DIVERSIFIED SYSTEMS, INC
Entity type:Organization
Organization Name:NURSES DIVERSIFIED SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ANN BROWN
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:907-374-0852
Mailing Address - Street 1:815 2ND AVE STE 122
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4469
Mailing Address - Country:US
Mailing Address - Phone:907-374-0852
Mailing Address - Fax:907-374-0854
Practice Address - Street 1:219 1ST AVE S STE 310
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2551
Practice Address - Country:US
Practice Address - Phone:907-374-0852
Practice Address - Fax:907-374-0854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty