Individual
TULA DESHA JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14823 WINSTON FALLS LN, HUMBLE, TX 77396-6073
(214) 808-7889
Mailing address
14823 WINSTON FALLS LN, HUMBLE, TX 77396-6073
(214) 808-7889
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
867767
TX
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1144604
TX
Other
Enumeration date
03/19/2022
Last updated
07/12/2024
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