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General NPI Number Information
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NPI Number | 1376309484
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Entity Type | Organization
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Legal Business Name | JJD PROFESSIONAL CARE AND HEALTH SERVICES LLC
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 236 IVY LN CHASE LOOP
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City | DALLAS
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State | GA
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Zip | 30157-5599
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Country | US
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Telephone | 770-885-0391
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Fax |
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Provider Business Mailing Address
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Address Line | 236 IVY LN CHASE LOOP
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City | DALLAS
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State | GA
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Zip | 30157-5599
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Country | US
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Telephone | 770-885-0391
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Fax |
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Authorized Official
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Title or Position | NP
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Name | MRS. JUDITH E UGORJI
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Credential | NP
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Telephone | 770-885-0391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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