Individual
KENDALL JEFFERSON
Active
Individual
KENDALL JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201809827RN
OR
363LW0102X
Women's Health Nurse Practitioner
Primary
95014629
CA
Other
Enumeration date
12/14/2018
Last updated
07/27/2020
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