Healthcare Provider Details

I. General information

NPI: 1366933947
Provider Name (Legal Business Name): TRAVIS AUSTIN JEFFORDS DNP, FNP-BC, APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2018
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14797 PHILIPS HWY STE 201
JACKSONVILLE FL
32256-3746
US

IV. Provider business mailing address

11 GRAY WOLF TRL
PONTE VEDRA FL
32081-6052
US

V. Phone/Fax

Practice location:
  • Phone: 904-567-3998
  • Fax: 904-567-5790
Mailing address:
  • Phone: 904-424-7388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9326275
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: