Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 5101017162 | MI |
N | 207V00000X | Obstetrician & Gynecologist | OS11306 | FL |
Y | 207VX0201X | Gynecologic Oncologist | Q1836 | TX |
NPI | 1235335472 |
---|---|
Provider Name | Dr. Corinne Nicole Jeppson |
First Address | Dallas, TX 75391-1230 |
Second Address | San Antonio, TX 78240-5251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 26/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
349441102 | (05) | TX |
P01547630 | RAILROAD MEDICARE (01) | TX |