Provider Demographics
NPI:1134353758
Name:JEFFERYS, DORIS TODD (ANP)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:TODD
Last Name:JEFFERYS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3079 HALLSBORO RD N
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-6801
Mailing Address - Country:US
Mailing Address - Phone:910-646-3789
Mailing Address - Fax:
Practice Address - Street 1:614 N JK POWELL BLVD
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3008
Practice Address - Country:US
Practice Address - Phone:910-640-2611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004360363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health