Healthcare Provider Details

I. General information

NPI: 1720944218
Provider Name (Legal Business Name): LAURA ELAINE JEFFORDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10093 MOUNT CARMEL RD
BRIGHTON TN
38011-6915
US

IV. Provider business mailing address

10093 MOUNT CARMEL RD
BRIGHTON TN
38011-6915
US

V. Phone/Fax

Practice location:
  • Phone: 901-598-5026
  • Fax:
Mailing address:
  • Phone: 901-598-5026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCPM25120900
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: