Provider Demographics
NPI:1649415373
Name:JEFFERSON, APRIL C (STNA)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:C
Last Name:JEFFERSON
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 N GREEN ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121-1011
Mailing Address - Country:US
Mailing Address - Phone:937-213-1380
Mailing Address - Fax:
Practice Address - Street 1:432 N GREEN ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-1011
Practice Address - Country:US
Practice Address - Phone:937-213-1380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400787990708376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide