Provider Demographics
NPI:1194491993
Name:RHEA J JEFFERS APRN-CNP LLC
Entity type:Organization
Organization Name:RHEA J JEFFERS APRN-CNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHEA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JEFFERS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP
Authorized Official - Phone:937-239-5644
Mailing Address - Street 1:3085 WOODMAN DR STE 205
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1171
Mailing Address - Country:US
Mailing Address - Phone:937-502-1069
Mailing Address - Fax:937-660-6422
Practice Address - Street 1:3085 WOODMAN DR
Practice Address - Street 2:SUITE 205
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45420-1171
Practice Address - Country:US
Practice Address - Phone:937-502-1069
Practice Address - Fax:937-660-6422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty