Provider Demographics
NPI:1073112066
Name:JEFFUS, COURTNEY (FNP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:JEFFUS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:SAVAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5127 OLDENBURG RD NW
Mailing Address - Street 2:
Mailing Address - City:ROXIE
Mailing Address - State:MS
Mailing Address - Zip Code:39661-6076
Mailing Address - Country:US
Mailing Address - Phone:601-597-5308
Mailing Address - Fax:
Practice Address - Street 1:54 SGT PRENTISS DR
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-4726
Practice Address - Country:US
Practice Address - Phone:601-443-2680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904224363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily