Healthcare Provider Details

I. General information

NPI: 1750764056
Provider Name (Legal Business Name): DR. AMANDA JEPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2015
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982167 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2167
US

IV. Provider business mailing address

982167 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2167
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-8125
  • Fax: 402-559-5137
Mailing address:
  • Phone: 402-955-8125
  • Fax: 402-559-5137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number2080P0202X
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7468
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: