MEDICARE: JENNA LYNN JEFFRIES PA

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1306627328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA LYNN JEFFRIES PA

Provider Business Mailing Address
First Line	:	1832 W 57TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-3209
Country	:	US
Telephone Number	:	440-227-2142
Fax Number	:

Provider Business Practice Location Address
First Line	:	24700 CENTER RIDGE RD STE 380
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-5665
Country	:	US
Telephone Number	:	855-940-4867
Fax Number	:

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

Provider Enumeration Date	:	10/06/2023
Last Update Date	:	08/21/2025

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