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PRIVATE DUTY NURSING SERVICE NPI 1154754620


NPI Information

NPI: 1154754620
Provider Name: PRIVATE DUTY NURSING SERVICE
Classification: Skilled Nursing Facility - 3140N1450X
Entity Type: Organization

Specialization: Nursing Care, Pediatric

Address:
1538 TROY DR APT 1
MADISON, WI
ZIP 53704
Phone: (231) 343-8538
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PRIVATE DUTY NURSING SERVICE is a nursing care and pediatric skilled nursing facility in Madison, WI. The provider is a nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. PRIVATE DUTY NURSING SERVICE NPI is 1154754620. The provider is registered as an organization entity type.

The provider's business location address is:

1538 TROY DR APT 1
MADISON, WI
ZIP 53704-074
Phone: (231) 343-8538

The provider's authorized official is Mustapha Kambi .
The authorized official title is Registered and has the following contact phone number (231) 343-8538.

The enumeration date for this NPI number is 8/19/2013 and was last updated on 8/20/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13140N1450XSkilled Nursing FacilityNursing Care, Pediatric19433930WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12241974MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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