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NPI Code Detail

MEDICARE: JENAE ALIESE JEPPSON PHARM D

MEDICARE: JENAE ALIESE JEPPSON PHARM D
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
1183500000XPharmacist18541NV

General Provider Information

NPI Number : 1376985770
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENAE ALIESE JEPPSON PHARM D
Provider Business Mailing Address
First Line : 3703 TIMBERLINE DR
Second Line :
City : CARSON CITY
State : NV
Zip : 89703-7501
Country : US
Telephone Number : 775-220-7005
Fax Number :
Provider Business Practice Location Address
First Line : 1465 E WILLIAM ST
Second Line :
City : CARSON CITY
State : NV
Zip : 89701-3278
Country : US
Telephone Number : 775-841-2790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2013
Last Update Date : 07/25/2013

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