Individual
MISS BEVERLY JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6562
(913) 684-6208
Mailing address
510 GRANT AVE, FORT LEAVENWORTH, KS 66027-1332
(913) 684-6531
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
544452
TX
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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