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Individual

IDA M JEFFERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LVN

Contact information

Practice address
6600 E BEN WHITE BLVD, AUSTIN, TX 78741-7537
(512) 445-7720
Mailing address
548 ARBORS CIR, ELGIN, TX 78621-5574
(410) 562-8238

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
84568
TX

Other

Enumeration date
06/26/2018
Last updated
06/26/2018
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