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JEFFERSON STREET CLINIC LLC NPI 1477289817


NPI Information

NPI: 1477289817
Provider Name: JEFFERSON STREET CLINIC LLC

Doing Business As: JEFFERSON STREET CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 19D2273838

Address:
618 JEFFERSON BLVD
LAFAYETTE, LA
ZIP 70501
Phone: (240) 481-7672
Get Directions

JEFFERSON STREET CLINIC LLC is a family medicine in Lafayette, LA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. JEFFERSON STREET CLINIC LLC NPI is 1477289817. The provider is registered as an organization entity type.
The provider Is Doing Business As Jefferson Street Clinic.

The provider's business location address is:

618 JEFFERSON BLVD
LAFAYETTE, LA
ZIP 70501-206
Phone: (240) 481-7672

The provider's authorized official is Beryl Wayi Yufenyuy .
The authorized official title is Nurse Practitioner and has the following contact phone number (240) 481-7672.

The CLIA number assigned to this NPI record is 19D2273838 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/27/2022 and was last updated on 12/28/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QH0100XClinic/CenterHealth ServiceNo
2261QX0100XClinic/CenterOccupational MedicineNo
3207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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