Healthcare Provider Details

I. General information

NPI: 1285023028
Provider Name (Legal Business Name): CHRISTINA MARIE JEPPERSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2015
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 E SECTION ST
MOUNT VERNON WA
98274-9124
US

IV. Provider business mailing address

2116 E SECTION ST
MOUNT VERNON WA
98274-9124
US

V. Phone/Fax

Practice location:
  • Phone: 360-428-1700
  • Fax: 360-848-4350
Mailing address:
  • Phone: 360-428-1700
  • Fax: 360-848-4350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60532445
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: