Provider Demographics
NPI:1649840836
Name:JEFFREYS, EMILY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:JEFFREYS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 GLOVER AVE
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2018
Mailing Address - Country:US
Mailing Address - Phone:334-489-4649
Mailing Address - Fax:334-475-3567
Practice Address - Street 1:806 GLOVER AVE
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2018
Practice Address - Country:US
Practice Address - Phone:334-489-4649
Practice Address - Fax:334-475-3567
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-151848363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty