Organization
EZNURSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHAN ALBERTO VASQUEZ RN (OWNER/CEO)
(770) 380-1173
Entity
Organization
Contact information
Practice address
1122 FINCHERVILLE RD, JACKSON, GA 30233-3433
(770) 380-1173
Mailing address
6595 ROSWELL RD UNIT G7195, ATLANTA, GA 30328-3152
(770) 380-1173
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
251E00000X
Home Health Agency
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
385H00000X
Respite Care
—
—
385HR2050X
Respite Care Camp
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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