Provider Demographics
NPI:1205001625
Name:JEFFRIES, ELIZABETH JEAN (CRNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JEAN
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 DIAMOND DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-4532
Mailing Address - Country:US
Mailing Address - Phone:256-922-7613
Mailing Address - Fax:256-922-7616
Practice Address - Street 1:400 DIAMOND DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4532
Practice Address - Country:US
Practice Address - Phone:256-922-7613
Practice Address - Fax:256-922-7616
Is Sole Proprietor?:No
Enumeration Date:2008-04-26
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-079425363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily