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General NPI Number Information
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NPI Number | 1194491993
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Entity Type | Organization
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Legal Business Name | RHEA J JEFFERS APRN-CNP LLC
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 09/29/2021
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Provider Practice Location Address
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Address Line | 3085 WOODMAN DR SUITE 205
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City | KETTERING
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State | OH
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Zip | 45420-1171
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Country | US
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Telephone | 937-502-1069
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Fax | 937-660-6422
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Provider Business Mailing Address
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Address Line | 3085 WOODMAN DR STE 205
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City | KETTERING
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State | OH
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Zip | 45420-1171
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Country | US
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Telephone | 937-502-1069
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Fax | 937-660-6422
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Authorized Official
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Title or Position | OWNER
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Name | RHEA J JEFFERS
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Credential | APRN-CNP
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Telephone | 937-239-5644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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