| Organization Name: | PROFESSIONAL NURSING SERVICES OF NA, LTD |
| NPI Number: | 1548337694 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | E EDWIN LAVENDER (CEO) |
| Mailing Address: | 107 Jackson St Gordon |
| State: | GA US |
| Postal Code: | 310313908 |
| Phone Number: | 4786285790 |
| Fax Number: | 4786282954 |
| NPI Enumeration Date: | 11/30/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 158 R 0001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |