Provider Demographics
NPI:1629853106
Name:JEFFERIES, OLIVIA (MS, RDN)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:JEFFERIES
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10081 JOPLIN ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-9390
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10081 JOPLIN ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-9390
Practice Address - Country:US
Practice Address - Phone:801-682-6249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2024-02-08
Deactivation Date:2023-11-27
Deactivation Code:
Reactivation Date:2024-02-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered