Individual
JEANETTE P JEFFERIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1050 WISHARD BLVD, 4TH FL, INDIANAPOLIS, IN 46202-2872
(317) 630-7979
Mailing address
8910 PURDUE RD, SUITE 500, INDIANAPOLIS, IN 46268-3161
(317) 871-8811
(317) 871-8833
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000204A
IN
363LG0600X
Gerontology Nurse Practitioner
71000204A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200173570
—
IN
Enumeration date
05/12/2006
Last updated
02/22/2012
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