Provider Demographics
NPI:1114236544
Name:JEFFRIES, MICHELE ELAYNE (RN)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:ELAYNE
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-1140
Mailing Address - Country:US
Mailing Address - Phone:216-731-8989
Mailing Address - Fax:
Practice Address - Street 1:538 SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-2150
Practice Address - Country:US
Practice Address - Phone:216-731-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 260586163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse