Individual
JEFFERSON ROBERT FRANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPSW/CCSS
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
1715
NM
Other
Enumeration date
04/01/2024
Last updated
12/30/2025
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