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NPI Code Detail

MEDICARE: ANDREA JOLYNNE JEPSON

MEDICARE: ANDREA JOLYNNE JEPSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist12435863-4701UT

General Provider Information

NPI Number : 1770439150
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA JOLYNNE JEPSON
Provider Business Mailing Address
First Line : 11895 W 10400 N
Second Line :
City : TREMONTON
State : UT
Zip : 84337-6742
Country : US
Telephone Number : 801-217-3133
Fax Number : 801-528-5067
Provider Business Practice Location Address
First Line : 1808 W 1800 N STE A
Second Line :
City : CLINTON
State : UT
Zip : 84015-8503
Country : US
Telephone Number : 801-217-3133
Fax Number : 801-528-5067
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2026
Last Update Date : 03/07/2026

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Directions to “ ANDREA JOLYNNE JEPSON ” Practice Location

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