Provider Demographics
NPI:1942642681
Name:VANEPS, JEAN (CNP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:VANEPS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 680
Mailing Address - Street 2:
Mailing Address - City:DEER RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:56636-0680
Mailing Address - Country:US
Mailing Address - Phone:218-624-6562
Mailing Address - Fax:218-249-1534
Practice Address - Street 1:708 DIVISION ST
Practice Address - Street 2:
Practice Address - City:DEER RIVER
Practice Address - State:MN
Practice Address - Zip Code:56636-8706
Practice Address - Country:US
Practice Address - Phone:218-246-6286
Practice Address - Fax:182-492-1534
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR951803364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist