Provider Demographics
NPI:1295257335
Name:FARVE, JAMESETTA
Entity type:Individual
Prefix:MRS
First Name:JAMESETTA
Middle Name:
Last Name:FARVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39384 W WORTHY RD
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-6258
Mailing Address - Country:US
Mailing Address - Phone:225-279-2493
Mailing Address - Fax:
Practice Address - Street 1:39384 W WORTHY RD
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-6258
Practice Address - Country:US
Practice Address - Phone:225-279-2493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA006244526343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)