Provider Demographics
NPI:1265647903
Name:JEFFERY, DOINA MARIE CISMAS (RN)
Entity Type:Individual
Prefix:MRS
First Name:DOINA
Middle Name:MARIE CISMAS
Last Name:JEFFERY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:DOINA
Other - Middle Name:MARIE
Other - Last Name:CISMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8701 OAKCREST PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-6204
Mailing Address - Country:US
Mailing Address - Phone:505-899-4326
Mailing Address - Fax:
Practice Address - Street 1:1501 SAN PEDRO DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5153
Practice Address - Country:US
Practice Address - Phone:505-265-1711
Practice Address - Fax:505-256-5764
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse