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Individual

MS. DEANN RICHELLE JEFFERSON-FERGUSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, NC-BC

Contact information

Practice address
3413 PLAINS ST, COPPERAS COVE, TX 76522-3593
(571) 403-2948
Mailing address
3413 PLAINS ST, COPPERAS COVE, TX 76522-3593

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
668693
TX
163WC1600X
Continuing Education/Staff Development Registered Nurse
668693
TX
174H00000X
Health Educator
Primary
668693
TX

Other

Enumeration date
05/31/2018
Last updated
01/14/2020
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