Provider Demographics
NPI:1235968223
Name:DIVINE INTERVENTIONS NURSE CONCIERGE SERVICES, PLLC
Entity type:Organization
Organization Name:DIVINE INTERVENTIONS NURSE CONCIERGE SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:RENAY
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:972-342-6297
Mailing Address - Street 1:165 OCEAN DR
Mailing Address - Street 2:
Mailing Address - City:GUN BARREL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75156-4288
Mailing Address - Country:US
Mailing Address - Phone:903-716-6525
Mailing Address - Fax:
Practice Address - Street 1:718 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GUN BARREL CITY
Practice Address - State:TX
Practice Address - Zip Code:75156-5309
Practice Address - Country:US
Practice Address - Phone:903-716-6525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center