Provider Demographics
NPI:1447978457
Name:NEIGHBORHOOD NURSE, LLC
Entity type:Organization
Organization Name:NEIGHBORHOOD NURSE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR, CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMIKA
Authorized Official - Middle Name:SHANTE
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-529-2027
Mailing Address - Street 1:3421 GENTLE BREEZE DR
Mailing Address - Street 2:
Mailing Address - City:UPPR MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-2549
Mailing Address - Country:US
Mailing Address - Phone:144-352-9202
Mailing Address - Fax:
Practice Address - Street 1:3421 GENTLE BREEZE DR STE A
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-2549
Practice Address - Country:US
Practice Address - Phone:443-529-2027
Practice Address - Fax:240-306-9503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-16
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care