Individual
KALISHA SHEVOIN JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
565 HERBERT ST, SAINT AUGUSTINE, FL 32084-4074
(904) 466-8993
Mailing address
565 HERBERT ST, SAINT AUGUSTINE, FL 32084-4074
(904) 466-8993
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
CNA23616
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
831531406
—
FL
Enumeration date
02/08/2019
Last updated
02/08/2019
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