Individual
BRADLEY AARON JEFFERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-4000
Mailing address
4320 HAZELWOOD AVE, KINGSPORT, TN 37664-4963
(423) 292-0797
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0000230362
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
34801
TN
Other
Enumeration date
05/25/2023
Last updated
10/10/2023
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