Provider Demographics
NPI:1891324257
Name:JEPSEN, SARA (APRN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:JEPSEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:QUIJANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:703 WILLOW BRANCH CT
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-5630
Mailing Address - Country:US
Mailing Address - Phone:813-966-2069
Mailing Address - Fax:
Practice Address - Street 1:703 WILLOW BRANCH CT
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-5630
Practice Address - Country:US
Practice Address - Phone:813-966-2069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11006685363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine