MEDICARE: CIARA NICOLE JEFFCOAT FNP-C

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	363LF0000X	Family Nurse Practitioner	API141666	TX

General Provider Information

NPI Number	:	1821614207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIARA NICOLE JEFFCOAT FNP-C

Provider Business Mailing Address
First Line	:	600 N CENTRAL EXPY STE 601
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-6938
Country	:	US
Telephone Number	:	972-424-6311
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N CENTRAL EXPY STE 601
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-6938
Country	:	US
Telephone Number	:	972-424-6311
Fax Number	:

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

Provider Enumeration Date	:	06/22/2020
Last Update Date	:	08/11/2023

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