Provider Demographics
NPI:1982907754
Name:J.M.B. QUALITY NURSING
Entity Type:Organization
Organization Name:J.M.B. QUALITY NURSING
Other - Org Name:AMETHYST CONCIERGE NURSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:JONIKA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ASHWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-565-8121
Mailing Address - Street 1:1420 SAPHIRE DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-8076
Mailing Address - Country:US
Mailing Address - Phone:678-216-7286
Mailing Address - Fax:
Practice Address - Street 1:1420 SAPHIRE DR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-8076
Practice Address - Country:US
Practice Address - Phone:678-216-7286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303474164W00000X
164W00000X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes305S00000XManaged Care OrganizationsPoint of Service
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty