Healthcare Provider Details

I. General information

NPI: 1619798402
Provider Name (Legal Business Name): JESSICA DONNYLE JEFFERS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66840 BELMONT MORRISTOWN RD
BELMONT OH
43718-9823
US

IV. Provider business mailing address

71660 SUNNY ACRES DR
MARTINS FERRY OH
43935-2318
US

V. Phone/Fax

Practice location:
  • Phone: 740-782-1031
  • Fax:
Mailing address:
  • Phone: 740-359-8628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0037791
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: