Provider Demographics
NPI:1053343830
Name:JEFFRIES, BRENDA (NP)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:NP
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 587
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:VA
Mailing Address - Zip Code:22727-0587
Mailing Address - Country:US
Mailing Address - Phone:540-948-6861
Mailing Address - Fax:540-948-6015
Practice Address - Street 1:1200 SUNSET LN STE 2210
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3376
Practice Address - Country:US
Practice Address - Phone:540-825-6100
Practice Address - Fax:540-825-1829
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024066130363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner