Healthcare Provider Details

I. General information

NPI: 1679607188
Provider Name (Legal Business Name): TERRY M. JEPSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 NASHVILLE RD
BOWLING GREEN KY
42101-5375
US

IV. Provider business mailing address

PO BOX 2697
BOWLING GREEN KY
42102-7697
US

V. Phone/Fax

Practice location:
  • Phone: 270-781-6164
  • Fax: 270-781-2484
Mailing address:
  • Phone: 270-745-1467
  • Fax: 270-745-1156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2361P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: