# MARK A JEPSON PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mark Alan Jepson
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114335221
- **Authorized official:** MARK ALAN JEPSON NP (OWNER)
- **Authorized official phone:** (208) 391-1043

## Contact information

- **Practice address:** 413 N ALLUMBAUGH ST, STE. 101, BOISE, ID 83704-9212
- **Practice address phone:** (208) 323-1125
- **Practice address fax:** (208) 323-9604
- **Mailing address:** 413 N ALLUMBAUGH ST, STE. 101, BOISE, ID 83704-9212
- **Mailing address phone:** (208) 323-1125
- **Mailing address fax:** (208) 323-9604

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | NP-902A | ID | Yes |

## Other

- **Enumeration date:** 08/01/2014
- **Last updated:** 02/03/2015