Healthcare Provider Details

I. General information

NPI: 1326849969
Provider Name (Legal Business Name): PAIGE TAYLOR JEFFERIS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 CLARK ST
CAMBRIDGE OH
43725-9614
US

IV. Provider business mailing address

1330 CLARK ST
CAMBRIDGE OH
43725-9614
US

V. Phone/Fax

Practice location:
  • Phone: 888-454-5157
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN.CNP.0038902
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: