Provider Demographics
NPI:1235670985
Name:JEFFREYS, LINDA MICHELLE (NP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MICHELLE
Last Name:JEFFREYS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:JEFFREYS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:408 MARTLING RD STE A-105
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35951-7208
Mailing Address - Country:US
Mailing Address - Phone:256-302-1663
Mailing Address - Fax:
Practice Address - Street 1:408 MARTLING RD STE A-105
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35951-7208
Practice Address - Country:US
Practice Address - Phone:256-302-1663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-113424363LA2100X
AL2016032066363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALA01690BOtherINDIVIDUAL MEDICARE NUMBER