Individual
SHANNON L JEFFERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, AGPCNP-BC, PNP
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-1415
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
CNP60684
NM
363LA2200X
Adult Health Nurse Practitioner
209011386
IL
Other
Enumeration date
03/26/2014
Last updated
03/28/2025
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