Individual
MS. JULIANNE VENISE JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
2912 N BEATON ST APT 11, CORSICANA, TX 75110-1258
(903) 851-5843
Mailing address
2912 N BEATON ST APT 11, CORSICANA, TX 75110-1258
(903) 851-5843
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
140192
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04489856
DRIVERS LICENSE
TX
Enumeration date
06/06/2018
Last updated
06/06/2018
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