Provider Demographics
NPI:1003370107
Name:JUSTJEN,LLC
Entity Type:Organization
Organization Name:JUSTJEN,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:STIERWALD
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:504-952-0523
Mailing Address - Street 1:50 TUPELO TRCE
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-6742
Mailing Address - Country:US
Mailing Address - Phone:504-952-0523
Mailing Address - Fax:
Practice Address - Street 1:50 TUPELO TRCE
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-6742
Practice Address - Country:US
Practice Address - Phone:504-952-0523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1447723853OtherN/A