Individual
JOHNESHIA PROFIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1011 E T R CLAY DR, HOLLANDALE, MS 38748-3109
(662) 820-0450
Mailing address
PO BOX 693, HOLLANDALE, MS 38748-0693
(662) 820-0450
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
899983
MS
163WH0200X
Home Health Registered Nurse
Primary
899983
MS
363L00000X
Nurse Practitioner
906430
MS
Other
Enumeration date
07/19/2019
Last updated
10/16/2024
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