Individual
JERRICK JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
100 COMMERCIAL PARK CT APT 145, MAUMELLE, AR 72113-6992
(501) 416-8867
Mailing address
100 COMMERCIAL PARK CT APT 145, MAUMELLE, AR 72113-6992
(501) 416-8867
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
11221112610
AR
163WR0400X
Rehabilitation Registered Nurse
Primary
218478
AR
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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