NPI 1053761304

Jesse Mamon

Practitioner Community Health Worker Ruston, LA

Practice location

Address: 2929 Highway 33, Ruston, LA 71270-1628
Phone: (318) 251-9904

Registered specialties

Community Health Worker Primary

Other Service Providers Taxonomy 172V00000X

Other Community Health Worker providers in Louisiana →

Registry record

NPI: 1053761304
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Jun 2016
Record last updated: 17 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.