Wendy Crystal Jefferson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704156995 Issued in MI

Practice address

1550 S Bassett St
Detroit, MI 48217-1643

Phone

(313) 282-1961

NPI assigned

Feb 2, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1033415484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 S BASSETT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482171643",
            "telephone_number": "313-282-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S BASSETT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482171643",
            "telephone_number": "313-282-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "WENDY",
        "middle_name": "CRYSTAL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-02",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704156995",
            "primary": true
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "MI",
            "license": "4704156995",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Klyn Jefferson
• Lecole Jefferson
• Linda Teresa Jefferson
• Rochelle M Jefferson, LMSW
• Sierra Nicole Jefferson
• Lauren Jeffery, OTRL
• Tonya Jeffery
• James J. Jeffries II, M.D.,FACP,SFHM
• Kathleen Lilly Jeffries, APRN
• Keturah Williams Jeffries, M.D.

• Registered Nurse in Detroit, MI
• Providers in Detroit, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.