Organization
PROFESSIONAL NURSING SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY WOOLARD WALLACE RN, MSN, PNP (CEO/OWNER)
(252) 247-6911
Entity
Organization
Contact information
Practice address
212 N 35TH ST, MOREHEAD CITY, NC 28557-3104
(252) 247-6911
(252) 247-1034
Mailing address
212 N 35TH ST, MOREHEAD CITY, NC 28557-3104
(252) 247-6911
(252) 247-1034
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC1437
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3407219
—
NC
05
—
3408380
—
NC
05
—
6600178
—
NC
05
—
6600179
—
NC
05
—
6600180
—
NC
05
—
6600207
—
NC
05
—
6600495
—
NC
05
—
6800224
—
NC
05
—
6800225
—
NC
05
—
6800226
—
NC
05
—
6800227
—
NC
05
—
6800356
—
NC
05
—
7100073
—
NC
05
—
7100074
—
NC
05
—
7100075
—
NC
05
—
7100078
—
NC
05
—
720297V
—
NC
05
—
7701469
—
NC
Enumeration date
09/29/2005
Last updated
01/09/2009
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