Provider Demographics
NPI:1023604998
Name:PROACTIVE NURSING SERVICES, PLLC
Entity type:Organization
Organization Name:PROACTIVE NURSING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DESTINU
Authorized Official - Middle Name:
Authorized Official - Last Name:UGWU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-805-9224
Mailing Address - Street 1:PO BOX 421854
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77242-1854
Mailing Address - Country:US
Mailing Address - Phone:832-805-9224
Mailing Address - Fax:979-773-8917
Practice Address - Street 1:17711 SAUKI LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2847
Practice Address - Country:US
Practice Address - Phone:832-563-9985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health