# MR. JARED JEREL WEAVER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1407471741
- **Gender:** Man
- **Credential:** CAREGIVER

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171W00000X | Contractor | — | GA | — |
| 3747A0650X | Attendant Care Provider | — | NULL | Yes |

## Other

- **Enumeration date:** 06/12/2020
- **Last updated:** 12/02/2020