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General NPI Number Information
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NPI Number | 1063309938
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Entity Type | Organization
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Legal Business Name | EKAA HEALTHCARE LLC
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 500I E WOODROW WILSON AVE
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City | JACKSON
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State | MS
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Zip | 39216-4538
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Country | US
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Telephone | 769-232-0501
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Fax |
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Provider Business Mailing Address
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Address Line | 46 MOSS FOREST CIR
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City | JACKSON
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State | MS
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Zip | 39211-2905
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Country | US
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Telephone | 769-232-0501
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSCELYN D JOHNSON
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Credential | FNP
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Telephone | 769-232-0501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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