MEDICARE: KATHERINE JEFFERS

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1831900034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE JEFFERS

Provider Business Mailing Address
First Line	:	8649 WINDSOR HILL BLVD
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-8458
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8649 WINDSOR HILL BLVD
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-8458
Country	:	US
Telephone Number	:	336-991-6216
Fax Number	:

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

Provider Enumeration Date	:	01/16/2025
Last Update Date	:	02/03/2025

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Directions to “ KATHERINE JEFFERS ” Practice Location

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