JUSTIN KEITH JETTON NPI 1376306936

NPI Information

NPI: 1376306936
Provider Name: JUSTIN KEITH JETTON
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
1310 N HEARNE AVE
SHREVEPORT, LA
ZIP 71107
Phone: (318) 676-5111
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Justin Keith Jetton is a peer specialist in Shreveport, LA. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. Justin Keith Jetton NPI is 1376306936. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1310 N HEARNE AVE
SHREVEPORT, LA
ZIP 71107-516
Phone: (318) 676-5111
Fax: (318) 676-5137

The enumeration date for this NPI number is 2/5/2024 and was last updated on 2/7/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	175T00000X	Peer Specialist			LOUISIANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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