MEDICARE: MRS. SUSAN MARIE JEFFRIES A.R.N.P. CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	ARNP 2064082	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225331028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN MARIE JEFFRIES A.R.N.P. CNM

Provider Business Mailing Address
First Line	:	205 DR MARTIN LUTHER KING JR ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-3109
Country	:	US
Telephone Number	:	727-824-6900
Fax Number	:	727-820-4275

Provider Business Practice Location Address
First Line	:	6350 76TH AVE N
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-3152
Country	:	US
Telephone Number	:	727-547-7780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2010
Last Update Date	:	12/16/2010

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