Provider Demographics
NPI:1215378732
Name:LEPPER, CONSTANCE LOUISE (FNP)
Entity Type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:LOUISE
Last Name:LEPPER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 SABIL DR
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-8737
Mailing Address - Country:US
Mailing Address - Phone:970-261-2535
Mailing Address - Fax:
Practice Address - Street 1:151 E. THIRD ST.
Practice Address - Street 2:
Practice Address - City:PALISADE
Practice Address - State:CO
Practice Address - Zip Code:81526-0190
Practice Address - Country:US
Practice Address - Phone:970-261-2535
Practice Address - Fax:970-464-0329
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0161663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily