Individual
BRIAN KEITH JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
200 MEDICAL PARK DR, STE 430, CONCORD, NC 28025-2982
(704) 403-5890
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5002525
NC
363LA2100X
Acute Care Nurse Practitioner
5002525
NC
Other
Enumeration date
11/13/2006
Last updated
07/15/2024
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