| Doctor Name: | MR. FRED SAMUEL JUSTICE |
| NPI Number: | 1053567065 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 359055 |
| Business Practice Address: | 2185 Deep Gap Rd Flat Rock, NC - 287315716 |
| Business Phone Number: | 8286858530 |
| Business Fax Number: | |
| Mailing Address: | 2185 Deep Gap Rd, FLAT ROCK |
| State: | NC |
| Postal Code: | 287315716 |
| Phone Number: | 8286858530 |
| Fax Number: | |
| NPI Enumeration Date: | 08/10/2008 |
| NPI Last Update Date: | 08/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 376K00000X |
| License Number: | 359055 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Nursing Service Related Providers |
| Taxonomy Classification: | Nurse's Aide |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) An unlicensed individual who is trained to function in an assistive role to the licensed nurse in the provision of patient/client activities as delegated by the nurse; (2) An individual trained (either on-the-job or through a formal course generally of less than one year) and experienced in performing patient or client-care nursing tasks that do not require the skills of a specialist, technician, or professional. Examples of tasks performed by nurses aides include changing clothes, diapers, and beds; assisting patients to perform exercises or personal hygiene tasks, and supporting communication or social interaction. Specific education and credentials are not required for this work. |