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General NPI Number Information
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NPI Number | 1033351895
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Entity Type | Individual
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Provider Name | REBECCA M. JEPPSON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/25/2009
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 15 MADISON PROFESSIONAL PARK
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City | REXBURG
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State | ID
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Zip | 83440-2057
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Country | US
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Telephone | 208-356-6185
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Fax | 208-356-0378
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Provider Business Mailing Address
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Address Line | 848 S 7TH W
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City | SUGAR CITY
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State | ID
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Zip | 83448-5060
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Country | US
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Telephone | 208-356-6185
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Fax | 208-356-0378
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | N16709
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP920A
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License Number State | ID
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