Provider Demographics
NPI:1184154841
Name:JEFFERSON, DIONNE S
Entity type:Individual
Prefix:
First Name:DIONNE
Middle Name:S
Last Name:JEFFERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WASHINGTON SQ BLDG 228
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2424
Mailing Address - Country:US
Mailing Address - Phone:440-539-0443
Mailing Address - Fax:
Practice Address - Street 1:8 WASHINGTON SQUARE BUILDING 22
Practice Address - Street 2:8 WASHINGTON SQUARE BUILDING 22
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44143
Practice Address - Country:US
Practice Address - Phone:440-539-0443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No251E00000XAgenciesHome Health