Healthcare Provider Details

I. General information

NPI: 1275304230
Provider Name (Legal Business Name): NICOLE A JEFFRIES MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 RIVER RUN CT
FRANKLINTON NC
27525-7042
US

IV. Provider business mailing address

234 BREEZEMONT DR
FUQUAY VARINA NC
27526-5535
US

V. Phone/Fax

Practice location:
  • Phone: 919-323-6844
  • Fax:
Mailing address:
  • Phone: 919-323-6844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: