Individual
BRANDY NICOLE JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1255 W 15TH ST STE 1025, PLANO, TX 75075-7253
(972) 673-0404
Mailing address
704 SALINE CREEK DR, GLENN HEIGHTS, TX 75154-7968
(469) 530-7167
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
201946
TX
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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