Provider Demographics
NPI:1710073234
Name:JEFFERY, NANCY (DRPH,MPH,RDN,LD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:JEFFERY
Suffix:
Gender:F
Credentials:DRPH,MPH,RDN,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 HARDEMAN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-4412
Mailing Address - Country:US
Mailing Address - Phone:478-960-1859
Mailing Address - Fax:
Practice Address - Street 1:1305 HARDEMAN AVE STE 200
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-4412
Practice Address - Country:US
Practice Address - Phone:478-960-1859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2025-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD001496133N00000X, 133NN1002X, 133VN1004X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric