Individual
NONI GAZELLE JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2030 WINDSOR RUN LN, MATTHEWS, NC 28105-0054
(704) 443-6250
Mailing address
5730 EXECUTIVE DR STE 230, CATONSVILLE, MD 21228-1762
(704) 443-6250
(704) 443-6279
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
248305
NC
363LA2200X
Adult Health Nurse Practitioner
Primary
5012215
NC
363LG0600X
Gerontology Nurse Practitioner
5012215
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000
—
NC
Enumeration date
08/20/2019
Last updated
03/19/2026
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