Provider Demographics
NPI:1447037486
Name:INDEPENDENT NURSE COMPANY, LLC
Entity type:Organization
Organization Name:INDEPENDENT NURSE COMPANY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DORAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:636-385-4559
Mailing Address - Street 1:3541 TARN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-8366
Mailing Address - Country:US
Mailing Address - Phone:636-385-4559
Mailing Address - Fax:314-754-9560
Practice Address - Street 1:920 1ST CAPITOL DR STE 203&204
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2734
Practice Address - Country:US
Practice Address - Phone:636-385-4559
Practice Address - Fax:314-754-9560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171400000XOther Service ProvidersHealth & Wellness Coach