ALEX CAMILLE JEFFERSON (NPI# 1588950919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588950919 |
| Entity Type | Individual |
| Full Name | ALEX CAMILLE JEFFERSON |
| Credential | PMHNP-BC |
| Practice Address |
935 State Route Vv Kennett MO 63857-3822 |
| Practice Telephone | 5738885925 |
| Mailing Telephone | 5738885925 |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2020-01-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 2011017684 | MO | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2020001065 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
935 STATE ROUTE VV |
| City | KENNETT |
| State | MO |
| Zip Code | 63857-3822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952503690 | Emily Jane Garrett-pruett | Nurse Practitioner | 935 State Route Vv, Kennett, MO 63857-3822 | 2007-06-04 |
| 1104447614 | Brittany Lytle | Case Manager/Care Coordinator | 935 State Route Vv, Kennett, MO 63857-3822 | 2020-05-06 |
| 1780210088 | Legusta Renee Perkins | Counselor | 935 State Route Vv, Kennett, MO 63857-3822 | 2020-03-18 |
| 1194356576 | Wanda Jean Goodrich | Licensed Practical Nurse | 935 State Route Vv, Kennett, MO 63857-3822 | 2020-02-04 |
| 1386291144 | Katie Erin Simmons | Behavior Technician | 935 State Route Vv, Kennett, MO 63857-3822 | 2019-08-26 |
| 1922655398 | Dylan Scott Crawford | Behavior Technician | 935 State Route Vv, Kennett, MO 63857-3822 | 2019-08-21 |
| 1356995823 | Emma Quillin | Counselor | 935 State Route Vv, Kennett, MO 63857-3822 | 2019-08-01 |
| 1609428424 | Jessica Elaine Britt | Behavior Technician | 935 State Route Vv, Kennett, MO 63857-3822 | 2019-07-11 |
| 1972167088 | Emmelee Jean Britton-harper | Case Manager/Care Coordinator | 935 State Route Vv, Kennett, MO 63857-3822 | 2019-04-24 |
| 1255994398 | Nancy Beth Copeland | Behavior Technician | 935 State Route Vv, Kennett, MO 63857-3822 | 2019-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992278139 | Fancilla Adams | Counselor | 925 State Highway V V, Kennett, MO 63857 | 2019-01-10 |
| 1962994418 | Kiana Alexis Brown | Behavior Technician | 925 Highway W, Kennett, MO 63857 | 2018-05-31 |
| 1568953636 | Doctors Health Group, Inc | Family Medicine | 1312 First Street, Kennett, MO 63857 | 2018-05-24 |
| 1003328873 | Ann Graf | Counselor | 925 Vv, Kennett, MO 63857 | 2017-11-01 |
| 1457872160 | Jessica Luster | Technician, Other | 1109 Jones St., Kennett, MO 63857 | 2017-07-03 |
| 1235669128 | Chandra Celeste Perkins-shannon | Case Manager/Care Coordinator | 925 Hwy V, Kennett, MO 63857 | 2017-06-14 |
| 1467991612 | Sarah Lobdell | Case Manager/Care Coordinator | 925 State Highway Vv, Kennett, MO 63857 | 2017-02-21 |
| 1881132900 | Brandy Rios | Community Health Worker | 935 State Hwy Vv, Kennett, MO 63857 | 2017-02-09 |
| 1295272060 | Johnny Marie Johnson | Case Manager/Care Coordinator | 925 Hwy Vv Family Counseling Center, Kennett, MO 63857 | 2017-01-31 |
| 1043756364 | Heather Bowman | Case Manager/Care Coordinator | 875 Hwy Vv, Kennett, MO 63857 | 2017-01-10 |
| Find all providers in zip 63857 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1376152546 | Chijioke Francisca Mbah | Nurse Practitioner | 900 Sw 33rd St, Lees Summit, MO 64082-4191 | 2020-07-23 |
| 1740807825 | Aldijana Sacic | Nurse Practitioner | 8525 Glenwood Dr, Saint Louis, MO 63126-1849 | 2020-07-06 |
| 1639796766 | Courtney Paige Schult | Nurse Practitioner | 431 Stonewater Dr, Pevely, MO 63070-3210 | 2020-07-06 |
| 1912524059 | Farah Lynn Shaddix | Nurse Practitioner | 1103 Warm Winds Dr, O Fallon, MO 63366-6327 | 2020-07-05 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1215551973 | Nicole Lynn Parker | Nurse Practitioner | 1000 Jackson St Apt 1, Saint Charles, MO 63301-2676 | 2020-05-28 |
| 1386273217 | Andrea Morrow Wright | Nurse Practitioner | 8833 N Congress Ave Apt 813, Kansas City, MO 64153-1991 | 2020-04-03 |
| 1700413580 | Solange-belle Boma | Nurse Practitioner | 6326 Ne 44th St, Kansas City, MO 64117-1687 | 2020-03-24 |
| 1063044626 | Beatriz Fortaleza | Nurse Practitioner | 2305 South 65 Highway, Bldg A., Marshall, MO 65340-3702 | 2020-02-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.