PROACTIVE NURSING INC. NPI 1902203441

NPI Information

NPI: 1902203441
Provider Name: PROACTIVE NURSING, INC.
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Organization

Specialization: Gerontology

CLIA Number: 05D2096693

Address:
8692 WAGERS CIR
HUNTINGTON BEACH, CA
ZIP 92647
Phone: (619) 887-2838
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PROACTIVE NURSING, INC. is a gerontology nurse practitioner in Huntington Beach, CA. PROACTIVE NURSING, INC. NPI is 1902203441. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8692 WAGERS CIR
HUNTINGTON BEACH, CA
ZIP 92647-027
Phone: (619) 887-2838

The provider's authorized official is Gemma E. Porsuelo .
The authorized official title is Coo and has the following contact phone number (619) 887-2838.

The CLIA number assigned to this NPI record is 05D2096693 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/27/2014 and was last updated on 11/27/2014.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology		CALIFORNIA	Yes

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: 4/28/2024

NPI Synchronization or Removal

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