Provider Demographics
NPI:1497351944
Name:JEFFERIS, RACHEL ANN (FNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:JEFFERIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:KS
Mailing Address - Zip Code:67003-2227
Mailing Address - Country:US
Mailing Address - Phone:620-513-0332
Mailing Address - Fax:
Practice Address - Street 1:501 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ANTHONY
Practice Address - State:KS
Practice Address - Zip Code:67003-2227
Practice Address - Country:US
Practice Address - Phone:620-513-0332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-79799-021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily