Individual
MRS. SHAMEKA NICOLE JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7614 PENNSYLVANIA AVE, SAINT LOUIS, MO 63111-3314
(314) 473-9175
Mailing address
7614 PENNSYLVANIA AVE, SAINT LOUIS, MO 63111-3314
(314) 473-9175
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2011039305
MO
Other
Enumeration date
04/26/2013
Last updated
04/26/2013
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