Provider Demographics
NPI:1902837230
Name:JEFFRIES-BAXTER, ROXANNE L (CRNP)
Entity Type:Individual
Prefix:MS
First Name:ROXANNE
Middle Name:L
Last Name:JEFFRIES-BAXTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 RONALD DR
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1353
Mailing Address - Country:US
Mailing Address - Phone:267-307-2077
Mailing Address - Fax:
Practice Address - Street 1:1150 FIRST AVE STE 501
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1316
Practice Address - Country:US
Practice Address - Phone:610-934-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011634363LF0000X
PASP022178363LP0808X
PATP004933H363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health