Individual
KHADIJAH KIANA JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7801 SAINT ANDREWS RD # B1, IRMO, SC 29063-2866
(803) 240-9950
Mailing address
7801 SAINT ANDREWS RD # B1, IRMO, SC 29063-2866
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
54448
SC
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
09/07/2024
Last updated
09/07/2024
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