Provider Demographics
NPI:1598842809
Name:JEFFERS, LAURIE SAYERS (NP)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:SAYERS
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CIRCLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760
Mailing Address - Country:US
Mailing Address - Phone:732-576-8997
Mailing Address - Fax:
Practice Address - Street 1:200 WHITE ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739
Practice Address - Country:US
Practice Address - Phone:732-741-8404
Practice Address - Fax:732-741-5119
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN07633800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S69878Medicare UPIN
022412Medicare UPIN