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NPI Code Detail

MEDICARE: ERNESHA JETT

MEDICARE: ERNESHA JETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1467221234
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERNESHA JETT
Provider Business Mailing Address
First Line : 1215 2ND AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-5244
Country : US
Telephone Number : 706-324-4061
Fax Number :
Provider Business Practice Location Address
First Line : 1215 2ND AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-5244
Country : US
Telephone Number : 706-324-4061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2023
Last Update Date : 12/21/2023

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Directions to “ ERNESHA JETT ” Practice Location

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