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
—
—
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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