Jeffers, Keven Wayne

Jeffers, Keven Wayne is an sole proprietor health care provider with primary practice located at 550 Sunset Trl , Jellico TN 37762-2343. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Jeffers, Keven Wayne can be contacted via phone (423) 784-5771.

Contact Information

Primary practice address
550 Sunset Trl Jellico TN 37762-2343
Phone: (423) 784-5771
Fax: (423) 455-0380
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA2407 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3646 Tennessee

Profile Details

NPI number 1609357953
LBN Legal business name Jeffers, Keven Wayne
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2018
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609357953 NPPES
Kentucky Other PA2407 STATE LICENSE
Kentucky Other 3646 STATE LICENSE
Kentucky MEDICAID 7100571470 STATE LICENSE
Kentucky MEDICAID Q045895 STATE LICENSE

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