Provider Demographics
NPI:1922269588
Name:JEFFERS, KRISTI GAIL (RT (R)(M)(CT))
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:GAIL
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:RT (R)(M)(CT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 TONGUE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-6215
Mailing Address - Country:US
Mailing Address - Phone:406-421-5664
Mailing Address - Fax:
Practice Address - Street 1:4340 TONGUE RIVER RD
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-6215
Practice Address - Country:US
Practice Address - Phone:406-421-5664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT25062471M2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M2300XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMammography