# MR. JEFFREY ROBERT SEVERSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1598298424
- **Gender:** Man
- **Credential:** LPN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 146M00000X | Intermediate Emergency Medical Technician | A2018904 | NULL | Yes |
| 164W00000X | Licensed Practical Nurse | P011001 | SD | — |

## Other

- **Enumeration date:** 04/07/2017
- **Last updated:** 04/07/2017