Individual
NATALIE WISE JEFFRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4331 CHURCHMAN AVE, STE 101, LOUISVILLE, KY 40215
(502) 364-0902
(502) 364-0099
Mailing address
4331 CHURCHMAN AVE, STE 101, LOUISVILLE, KY 40215-1164
(502) 364-0902
(502) 364-0099
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001040338
ANTHEM
KY
05
—
7100437600
—
KY
Enumeration date
08/25/2016
Last updated
07/30/2018
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