Provider Demographics
NPI:1164019022
Name:CREPPY, JEAN YVES
Entity Type:Individual
Prefix:MR
First Name:JEAN
Middle Name:YVES
Last Name:CREPPY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 QUAIL HILL ST
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-2092
Mailing Address - Country:US
Mailing Address - Phone:919-441-0435
Mailing Address - Fax:
Practice Address - Street 1:210 QUAIL HILL ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2092
Practice Address - Country:US
Practice Address - Phone:919-441-0435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty