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NPI Code Detail

MEDICARE: JOY ELLEN LEPO AGPCNP-BC

MEDICARE: JOY ELLEN LEPO AGPCNP-BC
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
1363L00000XNurse Practitioner4704216391MI

General Provider Information

NPI Number : 1982439899
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOY ELLEN LEPO AGPCNP-BC
Provider Business Mailing Address
First Line : 15491 LAKE AVE
Second Line :
City : GRAND HAVEN
State : MI
Zip : 49417-8506
Country : US
Telephone Number : 616-638-3840
Fax Number :
Provider Business Practice Location Address
First Line : 15491 LAKE AVE
Second Line :
City : GRAND HAVEN
State : MI
Zip : 49417-8506
Country : US
Telephone Number : 616-638-3840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2024
Last Update Date : 09/03/2024

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Directions to “ JOY ELLEN LEPO AGPCNP-BC” Practice Location

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