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General NPI Number Information
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NPI Number | 1699924803
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Entity Type | Organization
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Legal Business Name | JEFFERSON FIRST ASSIST PLLC
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 09/12/2008
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Provider Practice Location Address
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Address Line | 7777 FOREST LN
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City | DALLAS
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State | TX
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Zip | 75230-2505
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Country | US
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Telephone | 972-566-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 670039
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City | DALLAS
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State | TX
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Zip | 75367-0039
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Country | US
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Telephone | 214-378-9898
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Fax | 214-378-9888
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SUSANNE JEFFERSON
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Credential | RNFA
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Telephone | 972-897-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 650395
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License Number State | TX
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