Organization
TEAM NURSE INC
Active
Other names
Team Nurse - Altavista
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY M GLYNN (VICE PRESIDENT)
(434) 575-5200
Entity
Organization
Contact information
Practice address
621 BROAD ST, SUITE 1, ALTAVISTA, VA 24517-1829
(434) 309-2647
(434) 309-2642
Mailing address
621 BROAD ST, SUITE 1, ALTAVISTA, VA 24517-1829
(434) 309-2647
(434) 309-2642
Taxonomy
Speciality
Code
Description
License number
State
163WC2100X
Continence Care Registered Nurse
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
VA
3747P1801X
Personal Care Attendant
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942554357
PERSONAL CARE, RESPITE CARE, HIGH TECHNOLOGY WAIVER
VA
01
—
HCO-928
HOME CARE ORGANIZATION LICENSURE
VA
Enumeration date
11/07/2012
Last updated
08/15/2019
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