Healthcare Provider Details

I. General information

NPI: 1457156309
Provider Name (Legal Business Name): JMS SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 TARRAGON DR
DECATUR GA
30034-6207
US

IV. Provider business mailing address

3320 TARRAGON DR
DECATUR GA
30034-6207
US

V. Phone/Fax

Practice location:
  • Phone: 401-201-2424
  • Fax:
Mailing address:
  • Phone: 404-201-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. JOYCE A RICHARDSON
Title or Position: AUTHORIZED OFFICIAL
Credential: FNP-C
Phone: 404-201-2424