MEDICARE: KAYLA NICOLE JEFFRIES APRN, DNP

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	363L00000X	Nurse Practitioner	APRN11013722	FL
2	363LA2100X	Acute Care Nurse Practitioner	APRN11013722	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	:	1912678301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA NICOLE JEFFRIES APRN, DNP

Provider Business Mailing Address
First Line	:	PO BOX 100277
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32610-0225
Country	:	US
Telephone Number	:	352-265-0655
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 SW ARCHER RD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32610-3008
Country	:	US
Telephone Number	:	352-265-0655
Fax Number	:

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

Provider Enumeration Date	:	09/24/2021
Last Update Date	:	03/03/2022

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