Provider Demographics
NPI:1871885483
Name:JEFFERY, ALVIN D (MSN, RN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ALVIN
Middle Name:D
Last Name:JEFFERY
Suffix:
Gender:M
Credentials:MSN, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3333 BURNET AVENUE
Mailing Address - Street 2:ML5021
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:513-636-2039
Mailing Address - Fax:866-213-7089
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:PATIENT SERVICES APN/ML4019
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-5463
Practice Address - Fax:513-636-8893
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-15
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN.332819-COA1163W00000X
OHCOA.12900-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse