Individual
AMY C JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
709 S 13TH ST, TEMPLE, TX 76504-5401
(512) 804-6039
Mailing address
709 S 13TH ST, TEMPLE, TX 76504-5401
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
181428
TX
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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