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Organization
JMK COMMUNITY HEALTH CENTER, INC
Active
Organization
JMK COMMUNITY HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEANETTE MONIQUE KIDD FNP-C (CEO)
(424) 396-3412
Entity
Organization
Contact information
Practice address
14111 VAN NESS AVE, SUITE 5, GARDENA, CA 90249-2950
(424) 396-3412
(424) 396-3427
Mailing address
1112 N SANTA FE AVE, COMPTON, CA 90221-1427
(310) 638-1100
(424) 396-3427
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144584806
—
CA
Enumeration date
03/13/2017
Last updated
11/06/2019
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