Provider Demographics
NPI:1851583413
Name:KEPLER, JAN ELLEN (ARNP)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:ELLEN
Last Name:KEPLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11701 SAN JOSE BLVD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-0756
Mailing Address - Country:US
Mailing Address - Phone:904-288-6910
Mailing Address - Fax:904-288-6916
Practice Address - Street 1:11701 SAN JOSE BLVD
Practice Address - Street 2:SUITE 114
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-0756
Practice Address - Country:US
Practice Address - Phone:904-288-6910
Practice Address - Fax:904-288-6916
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9204450367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife