Carolyn Alina Jefferson, RN, BSN

Individual provider Active NPI Registered Nurse · Little Rock, AR

NPI 1841986288 · NPPES record last updated Apr 17, 2023

Key facts

NPI
1841986288
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R099323 (AR)
Practice address
9110 Geyer Springs Rd
Little Rock, AR 72209-6425
Phone
(501) 443-3170
NPI assigned
Apr 17, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R099323ARMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
God'S Grace Medical Staffing, LLC Registered Nurse Current
since May 7, 2023
Accepting new patients

Locations

9110 Geyer Springs Rd
Little Rock, AR 72209
Phone (501) 443-3170

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R099323 AR Yes

Addresses

Primary practice location

9110 Geyer Springs Rd
Little Rock, AR 72209-6425

Mailing address

9110 Geyer Springs Rd
Little Rock, AR 72209-6425
Phone (501) 443-3170

Other providers in Little Rock, AR

All providers in Little Rock, AR · Registered Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.