Active NPI
Professional Nursing Service, Inc
- Home Health Agency
- Morehead City, NC
National Provider Identifier
1669469250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- HC1437
- Legal business name
- PROFESSIONAL NURSING SERVICE, INC
- Practice address
- 212 N 35TH St
Morehead City, NC 28557-3104 - Phone
- (252) 247-6911
- Fax
- (252) 247-1034
- NPI assigned
- Sep 29, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Betty Woolard Wallace, RN, MSN, PNP
- Title
- Ceo/Owner
- Phone
- (252) 247-6911
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | HC1437 | NC | Primary |
Addresses
Primary practice location
212 N 35TH St
Morehead City, NC 28557-3104
Mailing address
212 N 35TH St
Morehead City, NC 28557-3104
Phone (252) 247-6911
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3407219 | Medicaid | NC | |
| 3408380 | Medicaid | NC | |
| 6800224 | Medicaid | NC | |
| 6800226 | Medicaid | NC | |
| 6800225 | Medicaid | NC | |
| 6800227 | Medicaid | NC | |
| 7100074 | Medicaid | NC | |
| 6600179 | Medicaid | NC | |
| 6600180 | Medicaid | NC | |
| 7100075 | Medicaid | NC | |
| 6600178 | Medicaid | NC | |
| 720297V | Medicaid | NC | |
| 7701469 | Medicaid | NC | |
| 6600207 | Medicaid | NC | |
| 6600495 | Medicaid | NC | |
| 6800356 | Medicaid | NC | |
| 7100073 | Medicaid | NC | |
| 7100078 | Medicaid | NC |
National Provider Directory
National Provider DirectoryLocations
940 Heather Park Dr
Garner, NC 27529
Phone (919) 662-1635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1231459200000",
"number": "1669469250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 N 35TH ST",
"city": "MOREHEAD CITY",
"state": "NC",
"postal_code": "285573104",
"telephone_number": "252-247-6911",
"fax_number": "252-247-1034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 N 35TH ST",
"city": "MOREHEAD CITY",
"state": "NC",
"postal_code": "285573104",
"telephone_number": "252-247-6911",
"fax_number": "252-247-1034"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROFESSIONAL NURSING SERVICE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-29",
"last_updated": "2009-01-09",
"status": "A",
"authorized_official_last_name": "WALLACE",
"authorized_official_first_name": "BETTY",
"authorized_official_middle_name": "WOOLARD",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "252-247-6911",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN, MSN, PNP"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NC",
"license": "HC1437",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3407219",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3408380",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6800224",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6800226",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6800225",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6800227",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100074",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6600179",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6600180",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100075",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6600178",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "720297V",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7701469",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6600207",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6600495",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6800356",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100073",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100078",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morehead City, NC
- Professional Nursing Service, Inc
- Professional Nursing Service, Inc
- Professional Nursing Service, Inc
- Professional Nursing Service, Inc
- Professional Nursing Service, Inc
- Professional Nursing Service, Inc
- Professional Nursing Service, Inc
- Professional Nursing Service, Inc
- Professional Nursing Service, Inc
- Professional Nursing Service, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.