Individual
MR. JERMAIN C PONCARDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
821 E BATTLEFIELD ST APT D26, SPRINGFIELD, MO 65807-5879
(417) 450-9372
Mailing address
821 E BATTLEFIELD ST APT D26, SPRINGFIELD, MO 65807-5879
(417) 450-9372
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
2019033355
MO
Other
Enumeration date
02/17/2021
Last updated
02/17/2021
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