Provider Demographics
NPI:1942080874
Name:JNR PROFESSIONALS LLC
Entity Type:Organization
Organization Name:JNR PROFESSIONALS LLC
Other - Org Name:FAMILY MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLIETT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:229-860-1295
Mailing Address - Street 1:117 1ST ST
Mailing Address - Street 2:
Mailing Address - City:RHINE
Mailing Address - State:GA
Mailing Address - Zip Code:31077-3044
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:117 1ST ST
Practice Address - Street 2:
Practice Address - City:RHINE
Practice Address - State:GA
Practice Address - Zip Code:31077-3044
Practice Address - Country:US
Practice Address - Phone:229-385-3000
Practice Address - Fax:229-385-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty