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General NPI Number Information
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NPI Number | 1982110573
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Entity Type | Organization
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Legal Business Name | JOHNES & GERALD, LLC
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 12/06/2018
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Provider Practice Location Address
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Address Line | 1229 E PLEASANT RUN RD STE 128
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City | DESOTO
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State | TX
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Zip | 75115-4211
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Country | US
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Telephone | 972-639-8144
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Fax | 972-692-8379
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Provider Business Mailing Address
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Address Line | 1229 E PLEASANT RUN RD STE 128
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City | DESOTO
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State | TX
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Zip | 75115-4211
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Country | US
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Telephone | 972-639-8144
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC; OWNER/MANAGING MEMBER
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Name | JOHNES BOGONKO MONYONCHO
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Credential | DNP
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Telephone | 469-951-0649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP122703
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License Number State | TX
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