Doctor Name: | KOBRA JEFFRIES |
NPI Number: | 1376920009 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 1000000015160 |
Business Practice Address: | 200 Poplar Ave Ste. 102 Memphis, TN - 381031959 |
Business Phone Number: | 9013561195 |
Business Fax Number: | 9015753328 |
Mailing Address: | 200 Poplar Ave, Ste. 102 MEMPHIS |
State: | TN |
Postal Code: | 381031959 |
Phone Number: | 9013561195 |
Fax Number: | 9015753328 |
NPI Enumeration Date: | 05/01/2015 |
NPI Last Update Date: | 05/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | 1000000015160 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |