Jefferson, Kalisha Shevoin

Jefferson, Kalisha Shevoin is an sole proprietor health care provider with primary practice located at 565 Herbert St , Saint Augustine FL 32084-4074. She recently has only one registered license in Agencies / Home Health, which is considered as her primary health care specialty. Jefferson, Kalisha Shevoin can be contacted via phone (904) 466-8993.

Contact Information

Primary practice address
565 Herbert St Saint Augustine FL 32084-4074
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X CNA23616 Florida

Profile Details

NPI number 1982169330
LBN Legal business name Jefferson, Kalisha Shevoin
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 8th, 2019
Last updated Feb 8th, 2019 - about 7 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 1982169330 NPPES
Florida MEDICAID 831531406

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