Provider Demographics
NPI:1407895618
Name:JEFFERSON-SABOOR, ANDREA RENEE (MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:RENEE
Last Name:JEFFERSON-SABOOR
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Gender:F
Credentials:MSN, FNP-C
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Mailing Address - Street 1:2140 PEACHTREE RD NW
Mailing Address - Street 2:SUITE 232
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1314
Mailing Address - Country:US
Mailing Address - Phone:404-231-4431
Mailing Address - Fax:404-231-5677
Practice Address - Street 1:2140 PEACHTREE RD NW
Practice Address - Street 2:SUITE 232
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1314
Practice Address - Country:US
Practice Address - Phone:404-231-4431
Practice Address - Fax:404-231-5677
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2011-12-19
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Provider Licenses
StateLicense IDTaxonomies
GARN103467363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA229631952AMedicaid
GA229631952AMedicaid