Provider Demographics
NPI:1134833973
Name:JEPSEN, KERRI SUE (RN)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:SUE
Last Name:JEPSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:SUE
Other - Last Name:CONNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:WINNEBAGO
Mailing Address - State:NE
Mailing Address - Zip Code:68071-9703
Mailing Address - Country:US
Mailing Address - Phone:712-253-3411
Mailing Address - Fax:
Practice Address - Street 1:205 BLUFF ST
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:NE
Practice Address - Zip Code:68071-9703
Practice Address - Country:US
Practice Address - Phone:712-253-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA083519163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator