Basic Information
| Provider Information | |||||||||
| NPI: | 1548524564 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JEFFERS | ||||||||
| FirstName: | NOELENE | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1220 12TH ST SE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200033722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027157900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3020 14TH ST NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200096865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027454300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2012 | ||||||||
| LastUpdateDate: | 12/07/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | RN1026940 | DC | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.