Individual
STEPHANIE RUTH JEFFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7605 FOREST AVE, SUITE 103, RICHMOND, VA 23229-4938
(804) 288-0055
(804) 288-2659
Mailing address
DEPT. 453 PO BOX 1000, MEMPHIS, TN 38148-0001
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024164983
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Y217A05
MEDICARE PTAN
VA
05
—
1245343938
—
VA
Enumeration date
08/16/2006
Last updated
05/23/2024
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