Healthcare Provider Details

I. General information

NPI: 1255296232
Provider Name (Legal Business Name): JERKIA RINNIX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8410 PIT STOP CT NW STE 120
CONCORD NC
28027-8259
US

IV. Provider business mailing address

1123 STONEHENGE LN
CHARLOTTE NC
28216-3098
US

V. Phone/Fax

Practice location:
  • Phone: 704-775-1415
  • Fax:
Mailing address:
  • Phone: 704-775-1415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number21065
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: