Provider Demographics
NPI:1891856829
Name:JEPSON, DIXIE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:DIXIE
Middle Name:ANN
Last Name:JEPSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DIXIE
Other - Middle Name:ANN
Other - Last Name:JEPSON HOLLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:786 LEXINGTON PARKWAY NORTH
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104
Mailing Address - Country:US
Mailing Address - Phone:651-293-1897
Mailing Address - Fax:651-488-1182
Practice Address - Street 1:786 LEXINGTON PARKWAY NORTH
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104
Practice Address - Country:US
Practice Address - Phone:651-293-1897
Practice Address - Fax:651-488-1182
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN001559111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN070727900Medicaid
MN350002372Medicare ID - Type Unspecified