Provider Demographics
NPI:1740143999
Name:JEFFRIES, STEPHANIE ENNETTE (DNP, RN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ENNETTE
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 S WOOD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3747
Mailing Address - Country:US
Mailing Address - Phone:312-996-4328
Mailing Address - Fax:312-996-9723
Practice Address - Street 1:1009 S WOOD ST FL 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3747
Practice Address - Country:US
Practice Address - Phone:312-996-4328
Practice Address - Fax:312-996-9723
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041430199163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse