Provider Demographics
NPI:1770987570
Name:JEFFRIES, MARIA (PMHNP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42009 VICTORY LN
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6269
Mailing Address - Country:US
Mailing Address - Phone:703-777-0800
Mailing Address - Fax:
Practice Address - Street 1:42009 VICTORY LN
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-6269
Practice Address - Country:US
Practice Address - Phone:703-777-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172128363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health