Provider Demographics
NPI:1467609057
Name:JEFFERS, NANCY SUE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:SUE
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9687 LARUE MT. VICTORY ROAD
Mailing Address - Street 2:
Mailing Address - City:LA RUE
Mailing Address - State:OH
Mailing Address - Zip Code:43332-8809
Mailing Address - Country:US
Mailing Address - Phone:740-499-3481
Mailing Address - Fax:
Practice Address - Street 1:9687 LARUE MOUNT VICTORY RD
Practice Address - Street 2:
Practice Address - City:LA RUE
Practice Address - State:OH
Practice Address - Zip Code:43332-8809
Practice Address - Country:US
Practice Address - Phone:740-499-3481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN233765163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse