Healthcare Provider Details

I. General information

NPI: 1235939026
Provider Name (Legal Business Name): BRIANNA JEFFERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 NEW SCOTLAND AVE
ALBANY NY
12208-3412
US

IV. Provider business mailing address

18 RAMSEY PL
ALBANY NY
12208-3012
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-3125
  • Fax:
Mailing address:
  • Phone: 518-698-1189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number984197
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: