Provider Demographics
NPI:1013759513
Name:DREPS, JENNIFER STARR (FNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:STARR
Last Name:DREPS
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 1:23210 26 MILE RD
Mailing Address - Street 2:
Mailing Address - City:OLIVET
Mailing Address - State:MI
Mailing Address - Zip Code:49076-9527
Mailing Address - Country:US
Mailing Address - Phone:269-245-9145
Mailing Address - Fax:
Practice Address - Street 1:8175 MILLETT HWY
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-8512
Practice Address - Country:US
Practice Address - Phone:517-721-3882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704329197163WX0106X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily