Organization
NURSES ON THE GO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANTONIETTE NICOLE JACKSON C.N.A. (PRESIDENT/OWNER)
(651) 443-6221
Entity
Organization
Contact information
Practice address
6449 RATH DRIVE, SAINT PAUL, MN 55125-1130
(651) 443-6221
(651) 286-2994
Mailing address
1321 EAST 78TH STREET, SUITE 114, BLOOMINGTON, MN 55425-1114
(651) 443-6221
(651) 286-2994
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
3747P1801X
Personal Care Attendant
—
—
374J00000X
Doula
—
—
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10794620
CERTIFIED NURSE ASSISTANT
MN
05
—
10794620
—
MN
Enumeration date
11/03/2020
Last updated
11/10/2020
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