Provider Demographics
NPI:1730245515
Name:PER DIEM NURSE STAFFING LLC
Entity type:Organization
Organization Name:PER DIEM NURSE STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERLY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:419-262-8884
Mailing Address - Street 1:18 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43566-1531
Mailing Address - Country:US
Mailing Address - Phone:419-878-8880
Mailing Address - Fax:419-878-4896
Practice Address - Street 1:18 N 3RD ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43566-1531
Practice Address - Country:US
Practice Address - Phone:419-878-8880
Practice Address - Fax:419-848-4896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health