Provider Demographics
NPI:1174149819
Name:JEFFRIES, EMILY M
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:M
Other - Last Name:JEFFRIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1040 E 346TH ST
Mailing Address - Street 2:
Mailing Address - City:EASTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44095-2629
Mailing Address - Country:US
Mailing Address - Phone:440-434-9400
Mailing Address - Fax:
Practice Address - Street 1:1040 E 346TH ST
Practice Address - Street 2:
Practice Address - City:EASTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44095-2629
Practice Address - Country:US
Practice Address - Phone:440-434-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health