Provider Demographics
NPI:1679334387
Name:NURSES DIRECT CONNECT LLC
Entity type:Organization
Organization Name:NURSES DIRECT CONNECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MAHIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:317-679-3031
Mailing Address - Street 1:5402 ALLISONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-5547
Mailing Address - Country:US
Mailing Address - Phone:317-679-3031
Mailing Address - Fax:
Practice Address - Street 1:5402 ALLISONVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-5547
Practice Address - Country:US
Practice Address - Phone:317-679-3031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center