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NPI Code Detail

MEDICARE: JEREMY JERMAINE WEATHERSPOON

MEDICARE: JEREMY JERMAINE WEATHERSPOON
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1467245936
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY JERMAINE WEATHERSPOON
Provider Business Mailing Address
First Line : 1901 WESTBANK EXPY STE 200
Second Line :
City : HARVEY
State : LA
Zip : 70058-4362
Country : US
Telephone Number : 504-504-5312
Fax Number :
Provider Business Practice Location Address
First Line : 1901 WESTBANK EXPY STE 200
Second Line :
City : HARVEY
State : LA
Zip : 70058-4362
Country : US
Telephone Number : 504-504-5312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2025
Last Update Date : 03/20/2026

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Directions to “ JEREMY JERMAINE WEATHERSPOON ” Practice Location

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