Provider Demographics
NPI:1528429602
Name:JEFFERS, RHEA J (APRN-CNP)
Entity type:Individual
Prefix:MS
First Name:RHEA
Middle Name:J
Last Name:JEFFERS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 W WENGER RD STE J
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2755
Mailing Address - Country:US
Mailing Address - Phone:937-239-5644
Mailing Address - Fax:937-771-0031
Practice Address - Street 1:12 W WENGER RD STE J
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2755
Practice Address - Country:US
Practice Address - Phone:937-239-5644
Practice Address - Fax:937-771-0031
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.18242363LF0000X
OH18242363LP0808X
OHCOA.18242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0161427Medicaid