Healthcare Provider Details

I. General information

NPI: 1992641658
Provider Name (Legal Business Name): OLIVIA JEFFERIES
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 OFFICE PARK RD STE 221
WEST DES MOINES IA
50265-2548
US

IV. Provider business mailing address

950 OFFICE PARK RD STE 221
WEST DES MOINES IA
50265-2548
US

V. Phone/Fax

Practice location:
  • Phone: 515-305-3474
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number118720
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: