Provider Demographics
NPI:1043989916
Name:JEPPESEN, JENAE RIPPLINER (BSW)
Entity Type:Individual
Prefix:
First Name:JENAE
Middle Name:RIPPLINER
Last Name:JEPPESEN
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 S UNIVERSITY AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-4427
Mailing Address - Country:US
Mailing Address - Phone:801-851-7123
Mailing Address - Fax:801-851-7137
Practice Address - Street 1:151 S UNIVERSITY AVE STE 1400
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-4427
Practice Address - Country:US
Practice Address - Phone:801-851-7123
Practice Address - Fax:801-851-7137
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program