Provider Demographics
NPI:1760446462
Name:JEFFREYS, FLORENCE SUE (RN MSN ANP)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:SUE
Last Name:JEFFREYS
Suffix:
Gender:F
Credentials:RN MSN ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3691 RUTGER AVE
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110
Mailing Address - Country:US
Mailing Address - Phone:314-977-4440
Mailing Address - Fax:
Practice Address - Street 1:1034 S BRENTWOOD
Practice Address - Street 2:STE 1120
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117
Practice Address - Country:US
Practice Address - Phone:314-726-1612
Practice Address - Fax:314-726-1653
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO052767163W00000X, 363L00000X, 363LA2200X
IL163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health