Kenneth D Jefferson Jr.
Individual provider Active NPI Health Educator · Middleville, MI
NPI 1568095628 · NPPES record last updated Feb 18, 2020
Key facts
- NPI
- 1568095628
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Health Educator 174H00000X
- Practice address
- 5623 Fieldstone CT
Middleville, MI 49333-8110 - Phone
- (616) 617-9461
- NPI assigned
- Feb 18, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | Yes |
Addresses
Primary practice location
5623 Fieldstone CT
Middleville, MI 49333-8110
Mailing address
5623 Fieldstone CT
Middleville, MI 49333-8110
Phone (616) 617-9461
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Middleville |
Other providers in Middleville, MI
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- Bret A Hoxworth
- Katie Elisabeth Irons
- Christina Jarvis
- Candace Ann Johnson
- Just Ask US, LLC
- Kortni Matteson DDS PLLC
- Tina McCall
- Kenzie Ann McManus
All providers in Middleville, MI · Health Educator in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.