MEDICARE: BRIANNA NICOLE JEFFERSON

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	225400000X	Rehabilitation Practitioner	AT003789	GA

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	:	1942896774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA NICOLE JEFFERSON

Provider Business Mailing Address
First Line	:	8259 WICKER AVE
Second Line	:
City	:	SAINT JOHN
State	:	IN
Zip	:	46373-8878
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3375 SPRING HILL PKWY SE APT 1034
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-6837
Country	:	US
Telephone Number	:	256-663-9172
Fax Number	:

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

Provider Enumeration Date	:	12/16/2020
Last Update Date	:	12/16/2020

Similar Medicare Providers

1578665188 — MR. JAMES ALLEN SUDBERRY DPM
Practice Location Address:

300 STONECREST BLVD STE 255
SMYRNA, TN
37167-6837

Practice Phone: 615-220-2982
Practice Fax: 615-220-2984

1114553922 — ALEC SEIGLE DPT
Practice Location Address:

2790 CUMBERLAND BLVD SE
SMYRNA, GA
30080-3048

Practice Phone: 770-270-3050
Practice Fax: 770-270-3051

1518819622 — DARIANNA BOUDART
Practice Location Address:

4250 CABRETTA DR SE
SMYRNA, GA
30080-6479

Practice Phone: 470-250-0046
Practice Fax:

1669324406 — CLEAR PATH HOME CARE AGENCY LLC
Practice Location Address:

1087 CREATWOOD CIR SE
SMYRNA, GA
30080-8212

Practice Phone: 478-442-1281
Practice Fax:

1548830144 — RENAL TREATMENT CENTERS MID ATLANTIC INC
Practice Location Address:

3240 S COBB DR SE STE 800
SMYRNA, GA
30080-4112

Practice Phone: 470-750-0587
Practice Fax: 470-750-0609

1205786720 — BIANCA LATOYA HAROLD LCSW
Practice Location Address:

1850 LAKE PARK DR SE STE 216
SMYRNA, GA
30080-7642

Practice Phone: 229-800-9695
Practice Fax: 617-807-0958

Directions to “ BRIANNA NICOLE JEFFERSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.