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Organization
TEAM NURSE II, INC.
Active
Organization
TEAM NURSE II, INC.
Active
Other names
Team Nurse
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY GLYNN (VP OF OPERATIONS)
(434) 575-5200
Entity
Organization
Contact information
Practice address
1372 W GRETNA RD STE B, GRETNA, VA 24557-2472
(434) 656-6000
(434) 656-1213
Mailing address
PO BOX 776, 606 BROAD STREET, SOUTH BOSTON, VA 24592-0776
(434) 575-5200
(434) 575-5054
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
497757
CCN/PTAN MEDICARE #
VA
01
—
49D2142019
CLIA CLINICAL LABORATORY IMPROVEMENT ADMENMENTS CMS
VA
01
—
65092
ACHC
VA
01
—
HCO0205
OLC VIRGINIA DEPT OF HEALTH
VA
Enumeration date
09/02/2016
Last updated
09/14/2018
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