Provider Demographics
NPI:1427838309
Name:JEFFREY, AMERETTE M (CNP)
Entity type:Individual
Prefix:
First Name:AMERETTE
Middle Name:M
Last Name:JEFFREY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:117 CAMINO DE VIDA STE 300
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:NM
Mailing Address - Zip Code:88435-2267
Mailing Address - Country:US
Mailing Address - Phone:575-472-4311
Mailing Address - Fax:877-651-0289
Practice Address - Street 1:1024 S PACIFIC STREET
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701
Practice Address - Country:US
Practice Address - Phone:505-426-2599
Practice Address - Fax:877-553-1272
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2025-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMCNP-75976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily