Individual
JOHNELLA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7492 BRITTNAY DR, SOUTHAVEN, MS 38672-8359
(901) 922-9816
Mailing address
7492 BRITTNAY DR, SOUTHAVEN, MS 38672-8359
(901) 922-9816
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
03/05/2019
Last updated
03/05/2019
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