Provider Demographics
NPI:1528490927
Name:JEFFERSON, MALIKA ADAMS (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MALIKA
Middle Name:ADAMS
Last Name:JEFFERSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66308
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77266-6308
Mailing Address - Country:US
Mailing Address - Phone:713-967-8699
Mailing Address - Fax:
Practice Address - Street 1:315 BERRY RD # T-1777
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-3209
Practice Address - Country:US
Practice Address - Phone:713-742-8151
Practice Address - Fax:713-695-2629
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX718205363LF0000X
TXAP124142363LS0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool