Organization
TEAM NURSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTY M. GLYNN (VICE PRESIDENT)
(434) 575-5200
Entity
Organization
Contact information
Practice address
330 MAIN STREET, BROOKNEAL, VA 24528
(434) 376-8240
(434) 376-8260
Mailing address
PO BOX 15, 330 MAIN STREET, BROOKNEAL, VA 24528-0015
(434) 376-8240
(434) 376-8260
Taxonomy
Speciality
Code
Description
License number
State
163WC2100X
Continence Care Registered Nurse
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
HCO-10449
VA
3747P1801X
Personal Care Attendant
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0152716988
—
VA
05
—
0152717952
—
VA
01
—
1497935753
PRIVATE DUTY MEDICAID
VA
01
—
HCO-09449
STATE LICENSURE
VA
Enumeration date
11/05/2007
Last updated
08/15/2019
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